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680 UNIT V Middle Range Nursing Theories

aims, what began as a descriptive substantive theory Beck’s work has also been instrumental in com-
of postpartum depression has evolved into an exten- munity intervention and education projects such as
sive research program. the Ruth Rhoden Craven Foundation for Postpartum
Depression Awareness located in South Carolina.
Acceptance by the Nursing Community Helena Bradford founded this organization because
of a tragic postpartum mood disorder within her
Practice own family. Ms. Bradford advocates for postpartum
As Beck’s research findings have been disseminated awareness within her community and conducts sup-
more widely, the theory and the instruments based on port groups (H. Bradford, personal communication,
the theory have been utilized increasingly in nursing April 28, 2004).
practice throughout the United States. In addition, the
PDSS is in use and translated as appropriate in Canada, Education
Australia, Brazil, New Zealand, Ireland, South Africa, Beck is a frequently invited speaker for professional
Germany, Russia, Turkey, Hungary, China, and Israel. educational conferences and workshops. Her work is
(The References section titled Bibliography of Research cited frequently in nursing maternal and newborn
Using the Screening Scale includes international use of nursing texts, such as that of Davidson, London, &
the PDSS.) Ladewig (2011). At both undergraduate and graduate
The PDSS became a standard of care for women in levels, Beck’s work sets the standard for knowledge
the high-risk obstetrical clinic of the Medical Univer- and understanding about postpartum depression. In
sity of South Carolina Hospital (A. Raney, personal addition, Beck’s work has been used to educate mem-
communication, April 28, 2004). The clients in this bers of other disciplines, such as physicians, mental
clinic vary in age across the spectrum, come from vari- health workers, public health professionals, social
ous ethnic backgrounds, and have a wide range of workers, and those who work in social service agen-
medical risk factors. She has noted that the tool is a cies that provide protective care for women and
vehicle for opening discussions with women that had children. Beck also brings her work to the general
not occurred prior to implementation of the tool. High public and policy makers through active community
scores on the PDSS have given physicians evidence to involvement at the local, state, national, and interna-
understand how postpartum depression is expressed in tional levels.
their patients, increasing their sensitivity and aware-
ness. Predictably, marshaling of community resources Research
to meet the specific needs of individual clients has been The long research development of Beck’s theory is
a challenge; however, the landscape for the Charleston evident in Table 34–1. As previously noted, she has
community in understanding and responding to the received numerous awards recognizing the impor-
special needs of women during this time has occurred. tance of her research. Nurses increasingly are using
Public health initiatives that involve working with Beck’s work for master’s and doctoral level research.
new mothers and babies are also utilizing Beck’s theory In addition, Beck facilitates practice implementation
of postpartum depression via the PDSS. For example, research for academic and nonacademic sites.
the Healthy Start CORPS: Inter-Conceptual Care Case
Management Project in North Carolina begins to fol-
low women when they are 6 weeks postpartum. All Further Development
new clients, many of whom are Native American, are Beck identified what became another major concept
given the PDSS so that intervention and management in her theory, as well as a restructuring of postpartum
strategies can be built into plans of care for individual mood disorder definitions (Beck, 2004a, 2004b).
women and their families (L. Baker, personal commu- Because of increasing reports of PTSD after childbirth,
nication, April 29, 2004). The director of the program she examined women’s experiences of traumatic
emphasizes the ease with which women are able to births (Beck, 2004a). In this work, birth trauma was
discuss symptoms of postpartum depression after com- defined as “an event occurring during the labor and
pleting the tool. delivery process that involves actual or threatened