Translation, cultural adaptation, and validation of the Greek version of the HERO-36 questionnaire

Abstract

Aim. The aim of this study was to translate, culturally adapt, and validate the HERO-36 questionnaire for health professionals in 12 public hospitals in Attica, Greece.

Material and methods. Linguistic and conceptual equivalence was achieved through a forward–backward translation process. A pilot test was conducted with 30 participants who completed the questionnaire twice, one week apart. Reliability was assessed through the use of Spearman correlation coefficients and Cronbach’s alpha. Additionally, six professionals practitioners (three nurses and three administrative staff) and a panel of five university experts reviewed the final version to enhance clarity and cultural relevance.

Results. The HERO-36 questionnaire translated in Greek demonstrated excellent test–retest reliability (Spearman r>0.89, p < 0.001) and high internal consistency, except for two subscales: “Typical Practices” (α=0.91), “Atypical Practices” (α=0.95), and “Outcome Measures” (α=0.89). Confirmatory factor analysis supported the factorial validity of the original structure. Minor phrasing changes were made to improve understanding and cultural adaptation.

Conclusions. The Greek version of the HERO-36 is a reliable and valid tool for assessing leadership and management practices among healthcare professionals during crises. It can be useful for research and team management in Greek hospitals, though further validation with larger, more diverse samples is recommended.