Page 698 - alligood 8th edition_Neat

CHAPTER 34 Cheryl Tatano Beck 679

to the brain, the more chronically deregulated the inductive and deductive logic significantly contrib-
brain becomes. Because an already deregulated uted to the development of the theory. Chinn and
brain is challenged again with new stressors (inter- Kramer (2011) identify inductive logic as founda-
nal or external), it is likely that serious mood and tional to qualitative methods, with reasoning from
psychiatric disorders will result. the particular to the general. In contrast, deductive
• Women’s unique and normal brain and hormonal reasoning moves from the general to the particular,
chemistry result in a vulnerability to mood disor- drawing conclusions that represent the general.
ders at critical times in their lives, including after Because Beck’s theory reflects a very complex and
giving birth. focused path in its evolution, it is helpful to be clear
• Postpartum depression is caused by a combination about what criteria were used to understand and pres-
of biological (including genetic), psychological, ent the theory. The definition of theory currently used
social, relational, economic, and situational life is… “a creative and rigorous structuring of ideas that
stressors. projects a tentative, purposeful, and systematic view
• Postpartum depression is not a homogenous dis- of phenomena” (Chinn & Kramer, 2011, p. 257).
order. Women may express postpartum depres- Middle-range theories may be derived using grounded
sion with a single symptom but are more likely to theory approaches, and they identify social processes
have a constellation of varying symptoms. This is that may occur in various social events. For example,
related to varying life histories of internal and Beck’s substantive theory of postpartum depression
external stressors. found that loss of control was the basic psychosocial
• Culturally, women are expected to feel happy, look problem facing women, but this problem could also
happy, act happy, understand how to be a mother occur in contexts other than the postpartum period.
naturally, and experience motherhood with a sense The evolution of Beck’s theory is instructional for
of fulfillment. These expectations make it difficult several reasons. First, Beck’s unceasing, linear, and
for women to express genuine feelings of distress. logical efforts to develop the theory for pragmatic
• The stigma attached to mental illness increases practice concerns led to a theory that addresses a
dramatically when a mental illness is related to the specific practice problem. Because her theory is rela-
birth of a child, leading women to suffer in silence. tively new, there are few contributors to the substance
• Within a level of prevention framework, postpar- of the theory. Therefore, there is opportunity to follow
tum depression can be prevented through identifi- a very clear and focused process of theory develop-
cation and mitigation of risk factors during the ment by a scholar who began the work as a young
prepartum period. Postpartum depression can be woman. Beck has tested her theory, used it with vari-
identified early with careful screening and can be ous populations, tested instruments, and developed
treated effectively. Prevention can alleviate months a work in which other scholars can join her to con-
of suffering and decrease the harmful effects on tribute to the science. Second, Beck’s theory of post-
women, their infants, and their families. partum depression is remarkable as an example of
• A number of biological, sociological, and psychologi- extensive inductive theory development in a specific
cal issues and challenges are entirely normal in all area of nursing practice addressing a specific patient
pregnancies. These may include fatigue, sleep altera- problem. Although Beck began her work with a
tions, questioning one’s abilities, and the like. Com- global understanding of caring, her focused work on
prehensive prenatal and postnatal care can eliminate postpartum depression was advanced through the
troublesome pathological symptoms and help women development of a substantive middle-range theory
normalize expected symptoms, thus reducing the and continues to advance. From the beginning, Beck’s
degree of stress they actually experience. goal has been to understand postpartum depression
in a way that would allow professionals to develop
adequate prevention strategies, develop screening
Logical Form programs for early intervention, and develop ade-
Beck’s Postpartum Depression Theory, as described in quate treatment strategies to prevent harm to women,
previous sections of this chapter, identifies how both their children, and their families. True to her research