Postpartum Depression Theory • Suicidal Thoughts

Cheryl Tatano Beck MAJOR ASSUMPTIONS

• “The birth of a baby is an occasion for joy—or so the • Nursing

saying goes . . . But for some women, joy is not an option.”
• Beck describes nursing as a caring profession with caring
Major Concepts and Definition obligations to persons nurses care for, students, and each
other. In addition, interpersonal interactions between nurses
• Postpartum Mood Disorders
and those for whom they care are the primary ways nursing
• Postpartum Depression accomplishes the goals of health and wholeness.

• Maternity Blues • Person

• Postpartum Psychosis • Persons are described in terms of wholeness with biological,

sociological, and psychological components. Furthermore,
• Postpartum Obsessive- Compulsive Disorder there is a strong commitment to the idea that persons or
personhood is understood within the context of family and
• Postpartum-Onset Panic Disorder
community.
• Loss of Control
• Health
• Encountering terror
• Beck does not define health explicitly. However, her writings
• Dying of self include traditional ideas of physical and mental health. Health
is the consequence of women’s responses to the contexts of
• Struggling to survive their lives and their environments. Contexts of health are vital
• Regaining control to understanding any singular issue of health.
• Environment
• Prenatal Depression
• Beck writes about the environment in broad terms that
• Child Care Stress include individual factors as well as the world outside of
each person. The outside environment includes events,
• Life Stress
situations, culture, physicality ecosystems, and sociopolitical
• Social Support systems. In addition, there is an acknowledgment that women
in the childbearing period receive care within a health care
• Prenatal Anxiety environment structured in the medical model and permeated
• Marital Satisfaction with patriarchal ideology.

• History of Depression • Health

• Infant Temperament • Beck does not define health explicitly. However, her writings
include traditional ideas of physical and mental health. Health
• Maternity Blues is the consequence of women’s responses to the contexts of
their lives and their environments. Contexts of health are vital
• Socioeconomic status
to understanding any singular issue of health.
• Marital Status

• Unplanned or Unwanted Pregnancy

• Sleeping and eating Disturbances

• Anxiety and Insecurity

• Emotional Lability

• Mental Confusion

• Loss of Self

• Guilt and Shame

Theory of Caring • Health

Kristen M. Swanson • According to Swanson, to experience health and well-being

• “Caring is a nurturing way of relating to a valued other
toward whom one feels a personal sense of commitment
and responsibility.”
Major Concepts and Definition
• Caring is a nurturing way of relating to a valued other
toward whom one feels a personal sense of commitment
and responsibility
is:
• “to live the subjective, meaning-filled experience of
wholeness. Wholeness involves a sense of integration and
becoming wherein all facets of being are free to be expressed.
The facets of being include the many selves that make us a
human: our spirituality, thoughts, feelings intelligence,
creativity, relatedness, femininity, masculinity, and sexuality, to
name just a few.”

• Knowing is striving to understand the meaning of an event in • Environment

the life of the other, avoiding assumptions, focusing on the
person cared for, seeking cues, assessing meticulously, and
engaging both the one caring and the one cared for in the
process of knowing
• Being with means being emotionally present to the other. It
includes being there in person, conveying availability, and
sharing feelings without burdening the one cared for
• Doing for means to do for others what one would do for self
if at all possible, including anticipating needs, comforting,
performing skillfully and competently, and protecting the
one cared for while preserving his or her dignity
• Swanson (1993) defines environment as situational. She
maintains that for nursing it is “any context that influences or
is influenced by the designated client” states there are many
influences on environment, such as the cultural, social,
biophysical, political, and economic realms, to name only a
few. According to Swanson (1993), the terms environment and
person-client in nursing may be viewed interchangeably
• Health
• According to Swanson, to experience health and well-being
is:

• Enabling is facilitating the other’s passage through life • “to live the subjective, meaning-filled experience of
transitions and unfamiliar events by focusing on the event, wholeness. Wholeness
informing, explaining, supporting, validating feelings,
generating alternatives, thinking things through, and giving
feedback
• Maintaining belief is sustaining faith in the other’s capacity
to get through an event or transition and face a future with
meaning, believing in other’s capacity and holding him or her
in high esteem, maintaining a hope filled attitude, offering
realistic optimism, helping to find meaning, and standing by
the one cared for no matter what the situation

MAJOR ASSUMPTIONS

• Nursing

• Swanson (1991, 1993) defines nursing as informed caring for

the well-being of others. She asserts that the nursing discipline
is informed by empirical knowledge from nursing and related
disciplines, as well as “ethical, personal and aesthetic
knowledge derived from the humanities, clinical experience,
and personal and societal values and expectations”
• Person

• Swanson (1993) defines persons as “unique beings who are

in the midst of becoming and whose wholeness is made
manifest in thoughts, feelings, and behaviors” (p. 352). She
posits that the life experiences individuals are influenced by
are a complex interplay of “genetic heritage, spiritual
endowment and the capacity to exercise free will”
Peaceful End-of-Life Theory

Cornelia M. Ruland

(1954–Present)

Shirley M. Moore

(1948–Present)

• “Standards of care offer a promising approach for the

development of middle-range prescriptive theories because of
their empirical base in clinical practice and their focus on
linkages between interventions and outcomes.”

• Not Being in Pain

• Being free of the suffering or symptom distress is the central

part of many patients’ end-of- life experience. Pain is an
unpleasant sensory or emotional experience that may be
associated with actual or potential tissue damage.

• Comfort is defined inclusively, using Kolcaba and Kolcaba’s

• (1991) work as “relief from discomfort, the state of ease
and peaceful contentment, and whatever makes life easy or
pleasurable”

• Experience of Dignity and Respect

• Each terminally ill patient is “respected and valued as a

human being” (Ruland & Moore, 1998, p. 172). This concept
incorporates the idea of personal worth, as expressed by the
ethical principle of autonomy or respect for persons, which
states that individuals should be treated as autonomous
agents, and persons with diminished autonomy are entitled to
protection

• Peace is a “feeling of calmness, harmony, and contentment,

[free of] anxiety, restlessness, worries, and fear” (Ruland &
Moore, 1998, p. 172). A peaceful state includes physical,
psychological, and spiritual dimensions.

• Closeness is “the feeling of connectedness to other human

beings who care” (Ruland & Moore, 1998, p. 172). It involves
a physical or emotional nearness that is expressed through
warm, intimate relationships.