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682 UNIT V Middle Range Nursing Theories

been found valid and reliable in studies (Beck, 2002b; The theory was influenced by various theoretical and
Hanna, Jarman, Savage, et al., 2004; Oppo, Mauri, philosophical stances, adding breadth and texture.
Ramacciotti, et al., 2009). An important feature of Maternity nurses are able to read the theory and under-
Beck’s theory is its immediate accessibility and dy- stand how to apply it in their practice. Beck and others
namic potential to impact women’s lives. continue to expand the theory by exploring its applica-
bility to different cultures and exploring ways of reach-
Importance ing women who have potential for its benefit.
The value of Beck’s work is of growing importance Increasingly, nurses and the wider society are rec-
within nursing and other disciplines. Perinatal mood ognizing that issues of postpartum depression have
disorders are obviously more than transient inconve- not been adequately understood or acknowledged.
niences for women and their families. The sequence Nursing, like other health care professions, has been
of events in the life of women (Meier, 2002) points to shocked by unanticipated events when postpartum
the extraordinary need for greater awareness and use depression leads to untoward outcomes that appear in
of Beck’s Postpartum Depression Theory for preven- the evening news. Even among nurses and other
tion, identification, early intervention, and treatment. health professionals, their knowledge does not miti-
There is a growing awareness that the responsibility gate the effects of this illness. These events point out
for identification and early intervention of postpar- the importance of this theory. Dr. Cheryl Tatano
tum depression belongs to more than those who are Beck’s work has demonstrated that nursing research
primarily responsible for caring for women during provides evidence to understand and prevent postpar-
pregnancy and immediately after birth (Beck, 2003; tum depression. Her research and instruments facili-
Kennedy, Beck, & Driscoll, 2002). Because of consis- tate detection, early intervention, and treatment.
tent interactions with mothers, pediatric and neonatal
nurses can make valuable contributions to successful
interventions for mothers suffering from postpartum CASE STUDY
depression. Psychiatric nurses might also be able to At the tender age of 11 years, Kim was “sold” by her
identify problems in women (or their children) that do mother to three adult men for an evening of sex
not immediately indicate postpartum depression. and drugs. Kim related that as her mother went out
However, knowledge about postpartum depres-
sion is developing in a way that sheds light on less the door, she advised her to “do what they tell you
and I’ll be back in the morning.” Kim was never
obvious consequences. Recently, postpartum depres- okay again. Although she did relatively well during
sion has been linked to adverse effects on children’s the sporadic times she went to school, her life was
cognitive and emotional development and behavior a series of drug and sex binges. At 17, Kim was in
problems of older children in school. Postpartum jail and pregnant. She had been arrested several
depression could have a negative effect upon situa- times and released, but the judge insisted that this
tions such as substance use, traffic accidents, criminal time she stay incarcerated until after the baby was
behaviors, domestic violence, progress in school, em- born to guarantee the baby would be crack-free at
ployment and income, and many others. A growing birth. Kim’s prenatal records, however, did not in-
awareness within nursing, other health care profes- dicate drug or alcohol use, and neither did her
sionals, and the public will allow greater identification jail records. She adamantly insisted that she never
of postpartum depression in the many contexts within used drugs or alcohol once she found out she was
which people live their lives.
pregnant (late in the first trimester). Through a
series of misunderstandings, she was released
Summary 2 weeks before the baby’s birth. However, Kim did
The development of Beck’s Postpartum Depression well, continued to stay drug-free, refused medica-
tion during labor, and delivered a beautiful healthy
Theory is the quintessential example of how creative baby—a baby whose blood test results were nega-
nursing knowledge is developed from nursing observa- tive for drugs.
tions, utilizing multiple methods and rigorous testing.