Cancer is the second major cause of death among people with psychotic disorders. With the same incidence, mortality in these patients remains higher than in the general population. As stigma has been identified as a risk factor for excess mortality, we focused on oncologists’ beliefs and attitudes towards people with psychotic disorders.

The aim of this study was to uncover physicians’ representations about the impact of psychosis on oncological care.

In this qualitative study, individual semi-structured interviews were conducted with 20 physicians working in oncology in the University Hospital of Brest (France). Transcribed interviews were thematically analyzed. This study meets the COREQ criteria.

Psychosis is described as a broad-spectrum condition whose severity ranges from the “mild” patient with imperceptible abnormality to the “severe” patient with cognitive and affective deficits. Oncologists identified behavioral and emotional symptoms which may modify the patient-physician relationship with difficulties to interact. Some of them consider that these patients are not interested in their health and will not get involved in oncological care. While the psychotic disorder is not considered as a limiting factor per se, oncologists felt concerned about being stigmatizing. They mentioned different aspects (like anticipation of non-compliance or inability to get help) that lead to changes in conventional treatment regimens and may result in a loss of opportunity.

Oncologists’ beliefs may lead to stigmatizing attitudes towards people with psychotic disorders who may not be given the best possible chances. Thus, these specific elements should be the basis for collaboration between psychiatrists and oncologists.

No significant relationships.

The purpose of this study was to determine the factors which influence advance directive (AD) completion among older adults.

Direct interviews of hospitalized and community-dwelling cognitively intact patients >65 years of age were conducted in three tertiary teaching settings in New York. Analysis of AD completion focused on its correlation with demographics, personal beliefs, knowledge, attitudes, and exposure to educational media initiatives. We identified five variables with loadings of at least 0.30 in absolute value, along with five demographic variables (significant in the univariate analyses) for multiple logistic regression. The backward elimination method was used to select the final set of jointly significant predictor variables.

Of the 200 subjects consenting to an interview, 125 subjects (63%) had completed ADs. In comparing groups with and without ADs, gender (p < 0.0002), age (p < 0.0161), race (p < 0.0001), education (p < 0.0039), and religion (p < 0.0104) were significantly associated with having an AD. Factors predicting AD completion are: thinking an AD will help in the relief of suffering at the end of life, (OR 76.3, p < 0.0001), being asked to complete ADs/ or receiving explanation about ADs (OR 55.2, p < 0.0001), having undergone major surgery (OR 6.3, p < 0.0017), female gender (OR 11.1, p < 0.0001) and increasing age (76–85 vs. 59–75: OR 3.4, p < 0.0543; <85 vs. 59–75: OR 6.3, p < 0.0263).

This study suggests that among older adults, the probability of completing ADs is related to personal requests by health care providers, educational level, and exposure to advance care planning media campaigns.