General limitations of this type of research are selection and response bias. The focus group participants may not be representative of healthcare worker and hospital populations and research in other settings may have produced different results. Group dynamics may have influenced individual participants' responses in a way perceived to be culturally desirable. Data from qualitative research is also generally at risk of decontextualisation and misinterpretation, perhaps more so in this case where the audio of four of six focus group sessions were back translated into English. Attempts were made to minimise this with the review of transcripts and analyses by the facilitators. Facilitators may have exhibited different interview techniques, potentially examining themes to varying extents, but they all had a common briefing and this approach permits identification of culturally specific factors. Not all EU countries were represented in this analysis and other cultural and structural differences may have generated different findings.