Cheryl Beck, a nurse, developed the concept of Postpartum Despair (PPD). This is an example of a middle range theory in nursing. Western Connecticut State University is where she did her undergraduate studies and graduated with a bachelor’s degree in nursing which serves as the foundation to her interests and her career. She undertook her postgraduate studies in Yale where she acquired her master’s degree which she specifically chose due to research training and clinical specialization. The degree was on maternal-newborn nursing and nurse midwifery. The purpose of this theory was to determine the causes of PPD and its manifestations which would thus enable the process of treating it. PPD is a type of depression that affects women after giving birth and is believed to be triggered by hormonal change. Feelings such as anxiety, irritability, sadness and a feeling of loss of value or blaming oneself that she is not being a good mother are common occurrences. It may also affect new fathers in some cases. She was amazed to discover that there was a connection between depression and alterations that take place in time which is believed to be the start of her interest in this topic. She thus believed that researchers in nursing needed to employ reliable and valid instruments in maternal-child research and target appropriate method similarity while selecting designs for research. She did her research on the concepts on the existing literature on clarified differences on them. A concept is an experience that has been mentally formulated. She came up with 11 themes she believed to bring out the real structure of PPD which she extended into her theory on PPD the following year. They included loneliness one found too much, solace found in the thought of death, thoughts that lead one to believe is a bad mother, thought that life will never revert to its normality, feeling of emptiness in life, constant dread of hurting their children, unclear thinking, being overwhelmed by feeling, loss of emotional control, anxiety that is over the limit and perceptions that one feels as a robot. She claimed the core problem was the feeling that they had lost control and the four stages they encountered were encountering relentless horrifying anxiety, feeling as if one is slowly dying, fighting to survive and getting back hold of their lives by control. The concepts included postpartum psychosis, postpartum depression and maternity blues. She did a study and came up with Assumptions she used in this theory is that participants in the research are competent in their experience and hence their knowledge important and accurate in the inquiry process. (Laisuk, 2004).
Middle range Theory
A theory is a hypothesis that that is creative in the structuring of its ideas and tries to explain and give detail about a phenomenon. It provides parameters on thoughts and disciplines and acts as linkages to concepts. There are three main types of theories; metatheory that gives a wide range of information on the phenomenon, microtheories that focuses only on a specific phenomenon and middle range theory. Middle range theory is believed to be a collection of ideas that are related and give ideas on the discipline of nursing and the reality. It was developed by Robert K Merton as a tool for bringing theory and empirical ideas together. They contain more concrete ideas compared to abstract ideas. He believed this was the key to advancement of sociology. It would also help in nursing due to the testable hypotheses generated from concrete phenomenon as compared to the abstract ideas. It also led to adaption of practices that weren’t in nursing to nursing leading to improved services. This theory applies across several practice settings due to the testability of the concepts which can be either empirical measures or hypothesis tested under conditions that are variable. Midrange theory addresses gaps encountered in theories through substantive provision of concrete information importance in development of the disciplines. The theory of Humanbecoming was developed by Rosemarie Rizzo Parse and its purpose is to guide nurses on practice that focuses on description and living of life as the quality of life. It is quite different from most theories of nursing in the bio-medical slant and bio-psycho-social-spiritual method. It doesn’t seek to correct problems rather shows the nurses opinions and perspectives of patients. The three principles are; structuring of the meaning is what brings out the picture and value of language. The second is configuring of patterns in a rhythm is the exposing-hiding and enabling-disabling of the joining-dismantling and the third is transcending with things that can be done is the powering and originating of change. It has three main concepts; meaning, rhythmicity and transcendence. Meaning implies that man’s reality is given sense through them creating what they value and the experiences they undergo and is from the first principle. Rhythmicity means that the living moment-to-moment is rhythmical and relating is a mutual process that shows advantages and disadvantages of interactions with other people and is from the second principle. Transcendence implies that human becoming is multidimensional and encourages reaching out beyond one’s limits and living is ambiguous with the changes hence one would reform constantly and is from the third principle. The concepts are pervaded by four assumptions; illimitability, inconsistency, freedom and clandestine. Illimitability is the uncontrolled knowledge with no boundaries that is up to infinity. Paradox is a pattern preference which is a rhythm expression and are not opposites or quandaries to be overwhelmed but rather rhythms to be existing. Liberty is situation in which one chooses what he wants with no policing. People have freedom to select conducts of being with their circumstances. Mystery is the incomprehensive conundrum that is not completely identifiable. Assumptions made about man are that he is coexistent with universe while obeying its rhythmical patterns, freedom to choose what he wants while at same time bearing the consequences, he is unitary thus maintains the patterns of relating while continually constituting new ones at the same time and that he transcends with the possibles multidimensionally at all times. Assumptions about becoming include that it is conjoined with health of living man, it is a co-constituting rhythm process between human and universe, it is a pattern by which humans relate their value priorities and also unites emerging of humans. This theory has both advantages and disadvantages and is unique from other theories in its provision of care and administration and a framework to inquiry of the other many inquiries. (Parse, 2004).
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Theory Grid
Purpose | G uide nurses on practices that focus on description and living of life as the quality of life. |
Concepts and Definitions |
Meaning implies that man’s reality is given sense through them creating what they value and the experiences they undergo and is from the first principle. Rhythmicity means that the living moment-to-moment is rhythmical and relating is a mutual process that shows advantages and disadvantages of interactions with other people and is from the second principle. Transcendence implies that humanbecoming is multidimensional and encourages reaching out beyond one’s limits and living is ambiguous with the changes hence one would reform constantly and is from the third principle. |
Theoretical Statements |
1st Principle-Structuring of the meaning is what brings out the picture and value of language. 2nd Principle-Configuring of patterns in a rhythm is the exposing-hiding and enabling-disabling of the joining-dismantling and 3rd Principal- Cotranscending with things that can be done is the powering and originating of change |
Structure and Linkages |
Illimitability is the uncontrolled knowledge with no boundaries that is up to infinity. Paradox is a pattern preference which is a rhythm expression. and are not opposites or dilemmas to be overcome but rather rhythms to be lived. Freedom is situation in which one chooses what he wants with no policing. People have freedom to choose ways of being with their situations. Mystery is the incomprehensive conundrum that is not completely identifiable. |
Assumptions |
Assumptions made about man are: he is coexistent with universe while obeying its rhythmical patterns, he has freedom to choose what he wants while at same time bearing the consequences, he is unitary thus maintains the patterns of relating while continually constituting new ones at the same time and that He transcends with the possibles, multidimensionally at all times. Assumptions about becoming include that: it is conjoined with health of living man, it is a co-constituting rhythm process between human and universe, it is a pattern by which humans relate their value priorities it unites emerging of humans |
Models | Unique from other theories in its provision of care and administration and a framework to inquiry of the other many inquiries |
References
Parse, R. (2004). A human becoming teaching-learning model. Nursing science quarterly. Published by Discovery International Publications, Pittsburgh. Pg. 33-35
Lasiuk, C., Ferguson, M. (2005). From practice to midrange theory and back again. Beck’s theory of postpartum depression. Pg. 127-134.