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674 UNIT V Middle Range Nursing Theories

Honor Society award for Best of Journal of Nursing evolution of grounded theory in nursing. Throughout
Scholarship-Profession, World Health, and Health all of Beck’s work and consistent with feminist theory,
Systems. there is explicit valuing of the importance of under-
Many in nursing recognize the classic Polit and standing pregnancy, birth, and motherhood through
Hungler research text, a fixture in countless graduate “the eyes of women” (Beck, 2002a). Furthermore,
nursing programs. Beck became coauthor of Polit’s Beck acknowledges that childbirth occurs in many
seventh edition (Polit & Beck, 2003), reflecting Beck’s simultaneous contexts (medical, social, economic)
research expertise. In 2011, this text received the and that mothers’ reactions to childbirth and mother-
American Journal of Nursing Book of the Year Award hood are shaped by their contextual responses.
for the 9th edition. Beck has also written articles re- An unusual theoretical source came from the
garding statistical analysis strategies and approaches work of Sichel and Driscoll (1999), who developed an
for qualitative research. earthquake model to conceptualize how interactions
Although Beck conducted seven major studies between biology and life result in what they term bio-
regarding educational and caring issues with under- chemical loading. Over time, with constant chemical
graduate nursing students, for over 3 decades she challenges related to stressors, women’s brains may
contributed to knowledge development in obstetrical develop a kind of “fault line” that is less likely to remain
nursing. Her research career began by studying women intact during critical moments in women’s lives, such
in labor, with interest in fetal monitoring. Beck’s research as the challenges women face around childbirth, result-
focus eventually became the postpartum period and ing in a kind of “earthquake.” Beck understood Sichel
specific studies of postpartum mood disorders. and Driscoll’s model to “suggest that a woman’s genetic
makeup, hormonal and reproductive history, and life
experiences all combine to predict her risk of ‘an earth-
Theoretical and Philosophical Sources quake’ which occurs when her brain cannot stabilize
Although Beck does not address caring as a theoreti- and mood problems erupt” (Beck, 2001, p. 276).
cal or philosophical construct specific to her research, Although it is easy to understand the physiological and
she has conducted studies that evidence her belief hormonal challenges of pregnancies for women, Sichel
about the importance of caring in nursing . Beck’s use and Driscoll’s earthquake model was important in
of the ideas of Jean Watson with regard to caring helping Beck to holistically conceptualize the phenom-
theory endorses caring as central to nursing, while ena that might affect the development of postpartum
acknowledging Watson’s concern that quantitative depression for women. Although Beck states that she
methodologies may not adequately reflect the ideal never experienced postpartum depression after the
of transpersonal caring. It is obvious throughout birth of her own children, those who have may relate
Beck’s writings, including research reports using both to the earthquake metaphor complete with tremors
quantitative and qualitative methods, that advancing culminating in postpartum depression or, worse, post-
nursing as a caring profession is desirable and achiev- partum psychosis.
able in practice, research, and education. Beck has identified Robert Gable as a particularly
Because many of the studies used to develop Beck’s important source in her work. As Professor Emeritus at
Postpartum Depression Theory were qualitative in the University of Connecticut, Neag School of Educa-
nature, Beck has cited various theoretical sources re- tion, Gable had coauthored an important text called
flecting the philosophical and theoretical roots of Instrument Development in the Affective Domain (Gable
methodologies important for the kind of knowledge & Wolf, 1993). After developing a wealth of knowledge
developed in each study. Phenomenology was used in about postpartum depression, the next logical steps for
the first major study of how women experienced post- Beck became developing instruments that could predict
partum depression, with Colaizzi’s (1978) approach. and screen for postpartum depression. Gable assisted
In her next study, Beck used grounded theory as Beck with theoretical operationalization of her theory
influenced by the theoretical and philosophical ideas for practical use. Gable has remained directly involved
of Glaser (1978), Glaser and Strauss (1967), and through the step-by-step development of the PDSS,
Hutchinson (1986), all seminal contributors to the including the Spanish version (Beck & Gable, 2003).