Becks Theory of Postpartum Depression free essay sample

Theory is an attempt to explain the world around us. It is defined as a set of concepts, definitions, and propositions that projects a view of phenomena by designating specific interrelationships among concepts for purposes of describing, explaining and predicting phenomena. In the world of healthcare the nurse through the understanding of theories attempt to explain why nurses do what they do. Nursing theories are the creative products of nurses who seek to thoughtfully describe relationships and interactions that exist within nursing practice (Ingram, 2009). Nursing theorist Cheryl Tatano Beck (1949- present) developed a middle-rang theory that focused on postpartum depression (PPD). Beck identified a significant gap in maternal care specifically in regard to maternal blues, she wrote: â€Å"What has not been given equal priority in postpartum follow-up care, however, is the mother’s psychological status, more specifically, the phenomenon of maternity blues. Early discharge mothers are at home when the blues usually occurs during the first week after delivery. Specific assessment for maternity blues should routinely be part of the nurse’s assessment of these mothers during home visits† (Lasiuk amp; Ferguson, 2005, p. 131). Beck, after reviewing research on the topic of maternity blues began clarifying the differences among the concepts of postpartum psychosis, postpartum depression, and maternity blues (Lasiuk amp; Ferguson, 2005, p. 131). This paper seeks to explore Beck’s theory of postpartum depression, its significance in nursing practice, and how it addresses the concepts of the metaparadigm of nursing; person (man), health, environment and nursing. Importance of Nursing Theory All nursing theory should lead to enhance nursing practice. Through theory, knowledge is gained and enhances the empowering of nurses; it aids in deliberate action and provides rationale when challenged, and provides professional autonomy by guiding practice, education and research. Theorists recognized the intrinsic value of theory for nursing as a means for defining and directing the profession and providing a base for further theoretical development, and if we consider that nursing is a science, then theory development is a fundamental activity (Ingram, 2009). Theory is also important to enhance communication in nursing; the way in which theory is expressed will influence its potential for communication between, theorists, researchers, and practitioners, and ultimately its applicability in practice. The importance of nursing theory is that it is purposeful and is of value to the development of practice from a developing body of nursing knowledge (Ingram, 2009). Lasiuk amp; Ferguson (2005, p. 128) noted that according to the American Nurses Association theory development should be the primary goal of the nursing profession. Summary of Beck’s Theory In 1992 Beck’s theory of postpartum depression was based on quantitative research design by collected data from interviews of women who attended PPD support groups. Beck identified 45 significant statements about women’s experience of PPD and identified 11 themes which explicate the fundamental structure of PPD (Lasiuk amp; Ferguson, 2005). The following year (1993) Beck extended those findings into a grounded theory of PPD, titled Teetering on the Edge. Beck chose a qualitative approach to the topic because she believed that the Beck Depression Inventory (BDI), a widely used instrument to detect depression, failed to accurately capture the horrifying experiences that she saw in her clinical practice (Lasiuk amp; Ferguson, 2005). This theory was developed to better understand PPD and to express it in a clear concise way that both professionals and public could digest. This was achieved by developing screening tools; promoting acceptance of PPD as well as interventions and treatments. This grounded theory has been classified as a middle-range theory, however, as new data is obtained the theory is modified to accommodate the varying conditions to increase the theory’s power, it was further classified as a substantive theory or SST. The SST is a subset of middle-range theory that is developed for a specific area of social concern, in this case women with PPD. Data for this theory was obtained through participant observation; analysis of the data revealed loss of control as the basic social psychological problem and was the foundation for her theory development (Beck, 2012). In relation to the nursing metaparadigm, Beck’s theory was intended for women with PPD and to serve as an educational tool for nursing students; healthcare professionals including nurses, doctors, mental health care workers and those within social services. Beck did not clearly define health; however, her focus was on mental health as PPD is a mental health disorder. Holistic health was a predominate factor in her theory, referring to the â€Å"wholeness† of a person, where the entire being, physically, emotionally, and psychologically are entwined with the environment as one. Beck determined that the interpersonal environment of the individual woman, if unstable, has an outward affect on them as well as on the family. Regardless of the setting of the individual’s environment, variables, be it rich or poor, famous or non famous, different cultures and backgrounds, all are subject to the effects of PPD (Lasiuk amp; Ferguson, 2005). Beck believed that obstetrical nurses as well as nurses outside of obstetrical nursing need to be educated to identify signs and symptoms of PPD, or those who may be at risk to ensure early intervention may take place. Beck’s theory was simplistically written so that nurses are able to read the theory, understand it, and apply it to their own practice setting (Lasiuk amp; Ferguson, 2005). As a prenatal nurse in a community care center setting, Beck’s theory broadened my views on PPD and how women have different interpretations of this experience. It made clear that women need to have the opportunity to express the negative feelings they may have as to their new role as mother; this will allow for them to work through any guilt or grief they may be experiencing. Nurses in the obstetrical field need to realize that before a client would seek help from healthcare professionals, mothers have to overcome their fear of being labeled and stigmatized. To help the mother cope, support from healthcare professionals as well as friends and family is primary and can be accomplished through education on PPD for everyone involved (Alligood amp; Tomey, 2006). View’s of Beck’s Theory In reviewing Beck’s theory of postpartum depression, assumptions of her theory include that her beliefs on nursing consists of interpersonal interactions as professionals with the purpose of accomplishing optimum health of an individual. Each person should be perceived as a whole consisting of biological, sociological and psychological components, and care should be a holistic approach. Beck noted that a women’s health is in response to the content of their lives and that all contexts should be understood, including their environment. Within the environment, there is a need for internal homeostasis or equilibrium to maintain physical and mental health; simultaneously the external environment plays an equal role in the affect on health, specifically ones shelter, culture, situations, events, family and friends (Lasiuk amp; Ferguson, 2005). Findings from 17 new transcultural qualitative studies of PPD provided evidence that prevalence of PPD is fairly consistent around the globe. Excerpts obtained from interviews of culturally diverse women by Beck are reference here: Beck reflects on her interaction with a Taiwanese mother who shared the depth of her suffering after childbirth: â€Å"During the tough time after the baby’s birth, my bluest period, I thought about committing suicide. I kept wondering what people live in the world for† (Beck, 2012, p. 270). Beck describes an Australian mother’s vivid recollection: â€Å"How I imagined hurting the baby was awful†¦you really don’t want anyone to know†¦if they did, they would want to put you away or take the baby away. I mean to say, why would you leave your baby with a mother who is thinking about putting him in a microwave. I used to see, in my mind, a pillow going over the head. So easy†¦the doctor says it’s only thoughts. I get that, but what sort of a person am I to even imagine such things? I have cried and cried over this. It was easier when I was numb and didn’t feel at all. At least I didn’t have these awful thoughts† (Beck, 2012, p. 267). The above dialogue exemplifies the process of Teetering on the Edge which refers to walking the fine line between sanity and insanity (Beck, 2012). Conclusion Postpartum depression is a common disorder that affects at least 19% of all pregnant women during the first 3 months after birth. Undiagnosed PPD can plunge mothers into despair rendering a mother disabled and placing the mother and infant at risk; at the least it will challenge the mother-infant relationship. PPD can last for years if untreated and cause unnecessary misery for women and their families (Cox amp; Holden, 2007). Beck progressed from identification of a clinical problem to exploring descriptive research, to concept analysis and midrange theory development. The final step was the application and testing of her theory in the clinical setting. Beck’s theory of PPD provided a context in development of nursing practice and knowledge, and for evaluating midrange theory. Beck’s theory can be utilized as a tool to advance the education of nurse students, nurses and other healthcare professionals. Nursing theorists have through their research and development of theory had contributed to the advancement of the professional nurse by guiding practice with evidence based knowledge and promoting a positive change in healthcare.