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Decisional Needs of Equity-Deserving Groups Diagnosed With Brain-Heart Conditions: A Mixed-Methods Study
Semhal Gessese1, Dawn Stacey2, Rosalyn Blackett3
1Semhal Gessese, RN, BScN, MScN, School of Nursing, Faculty of Health Science, University of Ottawa, Ontario, Canada; Registered Nurse, University of Ottawa Heart Institute, Ontario, Canada.
The Journal of Cardiovascular Nursing
|April 20, 2026
Summary
Equity-deserving patients with brain-heart conditions experience significant decisional conflict and regret. Tailored decision support is needed to address these unmet needs in healthcare.
Area of Science:
- Cardiology
- Neurology
- Health Equity
- Decision Science
Background:
- Brain-heart conditions disproportionately impact equity-deserving groups, leading to disparities in health decision-making.
- Little is known about the specific decisional needs of these vulnerable populations facing complex health choices.
Purpose of the Study:
- To investigate the decisional needs of patients from equity-deserving groups experiencing brain-heart conditions.
- To identify challenges and unmet needs in health decision-making for these populations.
Main Methods:
- An explanatory sequential mixed-methods study design was employed.
- Quantitative survey data (n=23) and qualitative interviews (n=5) were collected from adults (≥18 years) belonging to equity-deserving groups (racialized, LGBTQIA+, persons with disability) with brain-heart conditions.
Main Results:
- Decisions involved lifestyle changes (95.7%), medications (91.3%), and diagnostic tests (60.9%).
- High rates of decisional conflict (30.4%) and decision regret (30.0%) were observed.
- Key challenges included fear of making wrong choices and lack of discussion regarding brain implications, alongside information gaps, emotional complexity, and poor communication.
Conclusions:
- Equity-deserving patients with brain-heart conditions face substantial unmet decisional needs, including conflict and regret.
- Tailored decision support interventions are crucial to address these disparities and improve patient outcomes.
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