Fairness beyond equality: gender-responsive telehealth and the ethics of preparedness in post-stroke care

Fairness in cardiovascular care is often interpreted as the uniform delivery of standardized interventions. However, such an approach may overlook how individuals differentially experience, interpret, and benefit from care. In stroke recovery, informal caregivers play a pivotal role, yet preparedness for caregiving is unevenly distributed and shaped by gendered roles, relational identities, and contextual resources.

This study explores how fairness in post-stroke transitional care can be reconceptualized through a gender-responsive lens, examining how male and female caregivers differently construct preparedness during a nurse-led teletraining and telesupport intervention.

A qualitative study was conducted within a longitudinal nurse-led telehealth program supporting stroke survivor–caregiver dyads during the transition from hospital to home. Semi-structured interviews with caregivers were conducted one month after discharge and analysed using computer-assisted textual analysis. Lexicometric techniques, including Labbé’s intertextual distance and Correspondence Analysis, were applied to identify gender-specific patterns in caregiving narratives and interpretations of preparedness.

Caregiver preparedness emerged as a multidimensional and gendered process. Female caregivers predominantly framed preparedness through relational, affective, and moral dimensions, emphasizing emotional connection, family responsibility, and continuity of support. Male caregivers adopted a more situational and task-oriented perspective, defining preparedness as access to reliable guidance, coordination, and problem-solving capacity. The nurse navigator was central for both groups, functioning as a relational anchor for women and a procedural coordinator for men. These findings highlight that identical interventions can produce unequal experiential outcomes if caregiver diversity is not explicitly addressed.

Fairness in stroke care should move beyond equal provision toward equitable, responsive, and context-sensitive support. Nurse-led telehealth interventions that integrate flexibility, gender awareness, and digital inclusivity may better align care with caregivers’ lived realities. Embedding nurse navigators within transitional pathways represents a promising strategy to promote fairer preparedness, reduce caregiver burden, and ultimately improve recovery trajectories for stroke survivors.