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Limited evidence investigates how knowledge, misconceptions, and beliefs about palliative care vary across patients with cancerous versus non-cancerous chronic disease. We examined the knowledge of and misconceptions about palliative care among these groups.
We used weighted data from the National Cancer Institute Health Information National Trends Survey 5 (Cycle 2) for nationally representative estimates and logistic regression to adjust for respondent characteristics. We identified respondents who reported having (1) cancer ([n = 585]; breast, lung, and colorectal), (2) chronic conditions ([n = 543]; heart failure, lung disease, or chronic obstructive pulmonary disorder), or (3) neither cancer nor other chronic conditions (n = 2,376).
Compared to cancer respondents, chronic condition respondents were more likely to report being Black or Hispanic, report a disability, and have lower socioeconomic status. In the sample, 65.6% of cancer respondents and 72.8% chronic conditions respondents reported they had never heard of palliative care. Chronic condition respondents were significantly (p < 0.05) less likely to report high palliative care knowledge than cancer respondents (9.1% vs. 16.6%, respectively). In adjusted analyses, cancer respondents had greater odds of high palliative care knowledge (odd ratio [OR] = 1.70; 95% confidence interval [CI] = 1.01, 2.86) compared to respondents with neither cancer nor chronic disease; chronic condition respondents did not have increased odds (OR = 0.96; CI = 0.59, 1.54).
Significance of results
Disparities in palliative care knowledge exist among people with non-cancerous chronic disease compared to cancer. Supportive educational efforts to boost knowledge about palliative care remains urgent and is critical for promoting equity, particularly for underserved people with chronic illnesses.
This brief introduction outlines the book to follow, which will cover both core creativity scholarship and how the construct is linked to positive outcomes. The purpose of the present book is to offer an array of benefits related to creativity in order to help articulate the specific value of promoting, nurturing, and investing in creativity. The five components of the Creativity Advantage model are introduced for the first time: self-insight, healing, connection, drive, and legacy.
How do we define creativity? Studies of laypersons’ beliefs tend to find that people focus on malleability, aesthetic taste, insight, and curiosity. Experts, however, propose that for something to be creative it should be both novel or original and task-appropriate or useful. Although other criteria have been proposed, none has been as thoroughly adapted. After discussing why definitions do matter, I shift to theories that categorize creativity. I cover the classic model of the four Ps (Person, Product, Process, and Press) and then highlight a newer model that incorporates a sociocultural influence, the five As (Actor, Artifact, Action, Audience, and Affordances).
Creativity is connected to healing in many different ways. Creative people are more likely to experience post-traumatic growth or beneficial psychological changes that come in the aftermath of trauma. Creative activities can also help maintain emotional equilibrium. The cognitive reappraisal of seemingly negative events is associated with divergent thinking. Notably, the act of drawing, writing, or making music simply for the pleasure of the act can improve one’s mood by helping reduce sadness, anxiety, and anger. Even passively engaging in the arts can improve one’s mood and stave off potential cognitive decline.
In this ’afterward’ I try to reconcile the often discussed costs of being creative (especially at high levels) with the many benefits presented in this book. I ultimately come to the takeaway I am hoping the reader reaches: All small, good things count (and creativity can help).
This brief chapter acknowledges that creativity is not inherently benevolent. I discuss the idea of malevolent creativity, which designates creativity used for evil or bad purposes, and then I revisit the messy literature surrounding creativity and mental illness. Creativity’s benefits are not as simple or straightforward as drastically enhancing well-being (although there is a slight positive association).
We humans are the only species that knows that we will die. One way to cope is by aiming for symbolic immortality, so that a part of us may live on after our death. There are many potential pathways; one is through one’s creative works. Creators need not be geniuses to have their contributions live on, however. Many Pro-c creators may join forces on a larger project; and smaller-c creators may pass their everyday creative efforts (memoirs, scrapbooks, recipes) to be cherished by future generations.
Creativity is usually seen as a good thing, but why? The Creativity Advantage first offers an overview of creativity studies with an emphasis on the little-discussed benefits of being creative. These include how creativity can lead to self-insight, help people heal, forge connections with others, inspire drive, and enable people to leave behind a meaningful legacy. Written in an engaging style and illustrated with interesting anecdotal material, this book offers a new perspective on creativity scholarship that can serve as an introduction to the field for newcomers or as a way to encourage new avenues for research.
This chapter explores little-c, or everyday creativity, by providing an overview of the creative process. First, Graham Wallas’s initial model, which features the concepts of incubation and insight, is discussed. Then J. P. Guilford’s creative problem-solving model and subsequent additions and revisions are highlighted. I talk about the importance of problem finding before proceeding to the well-known concepts of divergent and convergent thinking. I proceed to discuss Paul Torrance and the Torrance Tests of Creative Thinking, along with other divergent thinking measures. I finish up with a quick mention of associational thinking and the Remote Associates Test.
Drawing on my own background as an aspiring writer, I highlight the core difference between little-c (everyday creativity) and Big-C (genius) before talking about the creation (with Ron Beghetto) of the four Cs model of creativity. Mini-c is creativity that is personally meaningful to the creator, even if it does not resound with others. Indeed, there are many reasons why creative work may not reach an audience, which is the topic of the CASE (Capital Awareness Spark Exceptionality) model. How does mini-c advance to little-c? One key is getting, and responding to, good feedback and critiques of one’s work. Another is improving creative metacognition, which has two parts: understanding your own creative strengths and weaknesses and knowing when (or when not) to be creative.
Returning to my lessons learned as a young writer, I talk about the journey from little-c to Pro-c and, potentially, to Big-C. Different nuances of Pro-c are explored, with a particular emphasis on creative domains. Drawing on the amusement park theory, I analyze which are the key domains or the larger areas that are most important for creativity. Exploring self-assessment measures, I reflect on how we measure creativity across domains in a way that demonstrates an art bias (and, to a degree, a bias in science) on the part of researchers. I then consider what it takes to have your creative efforts continue making an impact even after your death – a mix of your actual contributions, personal traits, level of influence, and simple luck.
What makes us want to create? I provide an overview of intrinsic and extrinsic motivation and their relationship with creativity before switching to needs, work orientation, and purpose. Creativity can help inspire us and drive us forward. It can be a source of passion or a vehicle to express it. We can enter the magical feeling of flow when we create. And across longer periods of time we can experience growth and have a sense of meaningful progress through creative work.