In the Hands of Strangers: The Myth of Choice and Self-Determination for Chronic Pain Patients in Ontario
Bibliographic record
Abstract
This study aimed to better understand and explain the lived experience of chronic pain patients within Ontario primary health care settings, their perceptions of self-determination, and the impact on their capacity to self-manage their condition and health-related quality of life. \n \nThrough in-depth interviews with 23 chronic pain (CP) patients, this research establishes an emergent theme of alienation as a key sensitizing characteristic of the experience of the research participants. \n \nSelf-Determination Theory suggests the management of pain is most effective when patients have a sense of agency and some measure of influence in their own health care. This view is consistent with the current provincial government policy of promoting Patient Centred Care (PCC). \n \nThe results of this study suggest that CP respondents experience feelings of alienation in the management of their condition. This experience is evidence of a lack of self-determination created by the inability of the health care professionals to effectively put into practice PCC.
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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 | 0.002 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.016 | 0.012 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.001 | 0.004 |
| 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".