, 2009, 239). When women begin to feel depressed, they often do not go find help or understand that this is an event that is more common than one would think. They tend to isolate their depression, which accelerates it even more. Advanced nurse practitioners and other nursing and clinical staff can help better provide for women by being accepting of their depression, rather than questioning it. Nursing staff can help ease some of the stress by not condemning the depressive feelings or symptoms, which typically make it worse. Rather, nursing staff can help the women identify with others who have undergone similar depressive states, thus helping them understand they are not alone and reducing the pressure to put on a facade, which only increases mental stress and accelerates the condition overall. Unfortunately, there are gaps in the literature in regards to the potential risk factors of PPD, leading to the importance of more clinical research in order to better understand the condition and how to treat it when it occurs. Once again, Beck has been crucial in helping outline risk factors, just as she was in defining the theoretical concepts of PPD in order to make it more understandable within clinical and nursing practice. Beck outlined in her original theoretical foundation a number of risk factors that may potentially be linked to higher incident rates of PPD, although these factors are abstract and thus hard to measure in a clinical setting exactly. Such factors include the presence of prenatal depression and anxiety, self-esteem levels both before and after pregnancy, stress over child care issues once the baby is born, any other stress related to the way the patient lives her life, the level of social support the new mother has, marital status, as well as the status of the pregnancy in terms of whether or not it was planned (Maeve, 726-727).

This is where Beck was crucial in pushing forward progress in how...

Throughout her long career, Beck helped generate systems to spot risk factors as a way to provide preventative measures for new mothers to be. One such contribution was the Postpartum Depression Predictors Inventory, which later revised into PDPI-R. The known risk factors were categorized based on their strength in correlation to PPD. Here, the research suggests that "the strongest predictors of PPD are the experience of depression and anxiety during pregnancy or a previous depressive illness" (Oppo et al., 2009 240). Understanding the risk factors better empowers nursing staff within the nursing metaparadigm to better care for their patients who may suffer from PPD shortly after giving birth. As "advanced nursing as a caring profession" which "is desirable and achievable in practice" it was a huge progress to define more categorical risk factor assessment tools (Maeve, 723). From such research, modern nurse practitioners can help spot early risk factors for signs of potential PPD, thus empowering care strategies to help accommodate certain psychological needs to strengthen a new mother's coping skills and quality of life. Beck was crucial in helping establish a stronger foundation for dealing with PPD both in clinical practice in theoretical conception. Her contributions as an advanced nurse practitioner then also show a larger notion that nursing research as a discipline can help set trends for clinical practice.