Perspectives of Ontarians with Multiple Sclerosis on Accessing Healthcare Services for Managing their Condition
Bibliographic record
Abstract
Multiple sclerosis (MS) requires complex care throughout life. Current Canadian literature demonstrates that persons with MS are high users of healthcare services, yet still have multiple unmet health care needs and low satisfaction with healthcare services received. This study investigated access to healthcare from the perspective of Ontarians with MS, using interpretive description methodology. Participants were 48 Persons with MS living across seven communities in Ontario recruited primarily through the MS Society of Canada. Data collection involved five focus groups plus ten individual semi-structured telephone interviews. Participants described access to healthcare services as a process of cost-benefit analysis that involved weighing out the likelihood of getting useful assistance against the range of expected barriers. Expected barriers were based on past experience and included a lack of patient-centered care, limited MS-related knowledge of generalists, and lack of affordability of preferred source of care. Ongoing experiences with these barriers led participants to believe that seeking care was not worth it. The result was that participants tended to avoid seeking healthcare services until they felt threatened by their health state, which then led to use of emergency services. Many participants also described completely disengaging from traditional healthcare services in favour of alternative treatments. Ontarians with MS report negative experiences with traditional healthcare services that fail to meet their complex care needs. Findings suggest that a patient-centered approach could reduce healthcare avoidance which may, in turn, reduce secondary complications and avoidable hospitalizations. (MS) requires complex care throughout life. Current Canadian literature demonstrates that persons with MS are high users of healthcare services, yet still have multiple unmet health care needs and low satisfaction with healthcare services received. This study investigated access to healthcare from the perspective of Ontarians with MS, using interpretive description methodology. Participants were 48 Persons with MS living across seven communities in Ontario recruited primarily through the MS Society of Canada. Data collection involved five focus groups plus ten individual semi-structured telephone interviews. Participants described access to healthcare services as a process of cost-benefit analysis that involved weighing out the likelihood of getting useful assistance against the range of expected barriers. Expected barriers were based on past experience and included a lack of patient-centered care, limited MS-related knowledge of generalists, and lack of affordability of preferred source of care. Ongoing experiences with these barriers led participants to believe that seeking care was not worth it. The result was that participants tended to avoid seeking healthcare services until they felt threatened by their health state, which then led to use of emergency services. Many participants also described completely disengaging from traditional healthcare services in favour of alternative treatments. Ontarians with MS report negative experiences with traditional healthcare services that fail to meet their complex care needs. Findings suggest that a patient-centered approach could reduce healthcare avoidance which may, in turn, reduce secondary complications and avoidable hospitalizations.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.016 | 0.005 |
| Scholarly communication | 0.005 | 0.002 |
| Open science | 0.001 | 0.003 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".