Health promotion and the human response to loss: clinical implications of a decade of primary health care research.

Ten years ago an academic group was established in Cardiff to determine why the public make life-style choices which are known to have an adverse impact on health and also to develop methods of measurement which describe trends in positive health motivation (salience) in the community. Three stages of this research are described in this paper and the results reveal a complex and fascinating set of human beliefs, attitudes and behaviours. Concern for health was not a consistent human characteristic and there was little evidence for the existence of a general preventive orientation in the cohorts studied. Discrepancies between expressed health beliefs/attitudes and behaviours are more explicable when the reality of ambiguity and paradox is recognized in human responses. Human responses to loss (grief) may have similarities to the respondents' experiences when facing a possible change of life-style for health reasons. The practical implications for primary care professionals are discussed.