*4.1.1.3 Difficulties in changing habits*

With the determination of personal behaviours that create an increase in disease risk, lifestyle behaviours have entered the agenda of many international institutions such as the European Cardiology Association, the American Diabetes Association, and the WHO. In 2019, the WHO published a self-care behaviours guide for health and well-being. Improvements in self-care have been brought about together with a change in habits.

A diagnosis of heart failure brings lifestyle changes such as disease-specific diet, perception and management of symptoms, drugs, regular medical check-ups, and exercise. Studies of patients with heart failure have reported that patients maintain self-care activities when symptoms become more severe or when they are hospitalised, but then return to previous habits when symptoms are alleviated or after discharge from hospital [20].
