Human Readiness for Stroke Telemedicine in a Greek Island Network: A Cross-Sectional Study

Ischemic stroke outcome depends on treatment speed, delayed in remote island areas by limited neurological coverage and patient transfer. Telemedicine offers remote support, but implementation depends on staff readiness (knowledge, attitudes, and exposure), undescribed in the Greek island context.

Cross-sectional survey of 135 health professionals (convenience sample) in an island hub-and-spoke network of 12 National Health System facilities; all self-reported. Two cross-culturally adapted instruments were used: the Acute Stroke Management Questionnaire (23-item knowledge score) and an attitude questionnaire based on diffusion of innovations theory. Analysis included reliability, correlation, group comparison, factor, and regression.

Stroke knowledge scores were relatively high (mean 3.95), lowest in advanced management, and differed by professional role (p = 0.015). Parallel analysis supported two correlated attitude factors rather than five: perceived value and usability (mean 3.57) and local visibility and workflow fit (mean 2.75), a gap of 0.82 points (p < 0.001). All had heard of telemedicine, but only 63% had seen a system in use. Prior exposure was associated with a more positive attitude bivariately (p = 0.016) but not after adjustment. Knowledge was associated with overall attitude (Spearman's ρ = 0.322; Pearson's r = 0.462; both p < 0.001) and with perceived value and usability (ρ = 0.435), but not with local visibility and workflow fit (ρ = 0.061).

In this self-selected sample, knowledge was associated with general appraisal of telemedicine, whereas no clear rank association was detected with perceived local integration. These exploratory findings identify targets for further evaluation without establishing the effects of education or organizational change.