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The factors that may limit the adherence to treatment can be divided in three categories: (1) regimen characteristics (e.g. difficulty of lifestyle changes), (2) disease characteristics (e.g. younger age of onset, frequency and severity of headache attacks), and (3) patient or family characteristics (e.g., premorbid/comorbid behavioral, psychopathology or dysfunctional family) [22, 33].
Account 4, which rejected the idea that patients with higher levels of education found lifestyle change easier, were the group most likely to emphasise the difficulty of lifestyle change and the importance of health professional intervention.
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However, several respondents commented about the difficulty of sustaining lifestyle modification over time.
Staff in this study (mainly female GPs) emphasised the need for respectful treatment and individual solutions, and showed an understanding of the difficulty of changing lifestyle.
Lifestyle intervention resulted in a small but significant temporary improvement of glycaemic control and only minimal changes in other known risk factors for diabetic complications, including blood pressure, indicating the difficulty of changing the lifestyle of patients with long-term diabetes.
Within their social networks many participants encountered people who lacked understanding of the relevance of unhealthy eating habits and lack of physical activity for health and who appeared to be unaware of the difficulty of the challenge of lifestyle change for individuals with CHD.
They shared their perceptions regarding the difficulty of changing long-standing lifestyle patterns.
A further relevant factor can be the difficulty of distinguishing between self-esteem, lifestyle, and appearance in the context of eating healthy food.
However, as discussed above, difficulties quantifying behavioral change may have influenced accuracy of lifestyle measurements.
The difficulties of compliance and secular trends in randomized trials of lifestyle factors are well known.
He is the newest member of the Cullen family, and thus has the most difficulty maintaining their lifestyle of feeding only on animals instead of humans.
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