AIM: To identify facilitators and barriers to home eating behaviors related to dietary management in patients with heart failure (HF) by comparing patient narratives and healthcare expert (HCE) perspectives against a patient-derived thematic framework. METHODS: We conducted a qualitative descriptive study using semi-structured interviews with patients with HF living at home (or planned discharge home) and HCEs involved in HF/dietary support. Data were collected at two collaborating hospitals in Japan (August 30, 2023 to May 2, 2024). Patient-derived themes/subthemes were developed first, and HCE narratives were then compared and coded against this structure to identify similarities and divergences. RESULTS: Seven patients with HF and six HCEs participated. Qualitative analysis yielded two domains (facilitators and barriers), five themes, and 23 subthemes. Facilitators included "External Support" and "Personal Capability and Internal Motivation" (e.g., family involvement/support, healthcare-provider guidance, and health-aligned home cooking). Barriers clustered into "Intrapersonal Factors," "Interpersonal and Social Factors," and "Contextual and Physical Limitations," capturing psychological burden and preferences, family/social situations, and socioeconomic constraints, and disruptions such as weather/seasonal patterns and fatigue-related limitations. CONCLUSION: The comparison revealed that while patients focused on practical habituation, physical effort, and maintaining interpersonal harmony, experts prioritized nutritional knowledge and broader socioeconomic or clinical risks. To bridge these differing perspectives, future research should focus on developing a brief self-assessment tool that encompasses both patients' lived experiences and expert-identified risks, enabling personalized dietary management tailored to patients' daily realities.