Development of the Parent-to-Infant Bonding Scale: Validation in Swedish Mothers and Fathers in Community and Clinical Contexts.

Valid measurement instruments are needed to investigate the impact of parental bonding on child health development. The aim was to develop and validate a self-report questionnaire, the Parent-to-Infant Bonding Scale (PIBS) to measure bonding in both mothers and fathers. Internal consistency and construct validity were analysed using data from Swedish parents from both clinical (N = 182), and community (N = 122) population samples. Overall, good or acceptable internal consistency of the PIBS appeared. Convergent validity (against the Postpartum Bonding Questionnaire, analysed in the clinical sample) and discriminant validity (against the mental health constructs of depressive symptoms and anxiety) were demonstrated. The results support the PIBS as a measure of maternal and paternal bonding in community and clinical populations. Assessments of criterion validity in these populations are desirable. The similarities in PIBS measurement properties between the parent groups suggest its usefulness for comparisons between mothers and fathers, and for future investigations of unique and interactive impacts of maternal and paternal bonding on child outcomes using community and clinical cohorts.

Study Circles as a Possible Arena to Support Self-Care-A Swedish Pilot Study.

Today, issues related to people's mental health and well-being have been described as a challenge for society, globally as well as in Sweden. This calls for new approaches to mental health promotion. The aim was to evaluate the adequacy of its content and structure, describing experiences of study circles as a means of supporting participants' self-care and self-compassion. The overall design is a descriptive QUAL + quan design, where the quantitative and qualitative results are integrated. Five participants participated in a focus group interview, of whom four completed questionnaires. One individual interview was conducted with the study circle leader. Study circles can be an arena for mental health promotion, as learning and sharing of experience contributes to a sense of coherence, as well as self-compassion and a genuine concern for one's own and others' well-being, but are not considered an alternative to psychiatric care for those in need of professional services. Study circles can be a possible means to support self-care and thereby promote mental health in the general population and are a valuable contribution to public health. However, in addition to modifications of the content, further research is needed on the qualifications for study circle leaders, as well as the dissemination of study circles.

Entrusting life to professionals: A phenomenological hermeneutical study of older persons' participation in prehospital emergency care involving municipal home care and ambulance services.

BACKGROUND: Participation in care is considered to promote safe and qualitative care. Care-dependent older persons ageing in place have increased emergency care needs, which initiate inter-organisational collaboration involving municipal home care and ambulance services. Previous research concludes that uncertainties exist regarding what participation in care means in clinical practice, which necessitates the need to illuminate the phenomenon for older persons in critical life situations. AIM: This study aimed to illuminate meanings of participation in prehospital emergency care from the perspective of care-dependent older persons experiencing acute illness at home. DESIGN: This study has a qualitative design with a lifeworld approach. METHOD: A phenomenological hermeneutical method was used to analyse transcribed telephone interviews with eleven care-dependent persons aged 70-93 years. RESULTS: Care-dependent older persons' participation in prehospital emergency care means 'Entrusting life to professional caregivers' when being in helpless solitude and existentially unsafe, which emphasises a deepened interpersonal dependence. Meanings of participation in care from the perspective of older persons involve Being reassured in togetherness, Being pliant in trust of emergency expertise, Being enabled through the agency of professional caregivers, and Encountering readiness in the emergency care chain. CONCLUSION: Care-dependent older persons' participation in prehospital emergency care is existential and involves interpersonal dependence. Togetherness brings reassurance, safety and opportunity for emotional rest while accessing the professional caregivers' power, competence and abilities which provide opportunities for existence and movement towards well-being and continued living. IMPLICATIONS FOR PRACTICE: Prehospital emergency care from the perspective of care-dependent older persons transcends organisational boundaries and includes the municipal mobile safety alarm service. The involved municipal and regional organisations need to provide support by implementing lifeworld-led care models and care alternatives that enable professionals to recognise the existential dimension of participation in care.

Balancing power: Ambulance personnel's lived experience of older persons' participation in care in the presence of municipal care personnel.

BACKGROUND: Patient participation is considered to promote well-being and is, therefore, central in care contexts. Care-dependent older persons living at home constitute a vulnerable population with increased ambulance care needs. Care transfers risk challenging participation in care, a challenge that can be accentuated in situations involving acute illness. AIM: To illuminate meanings of older persons' participation in ambulance care in the presence of municipal care personnel from the perspective of ambulance personnel. METHOD: A phenomenological hermeneutical method was used to analyse transcripts of narrative interviews with 11 ambulance personnel. RESULTS: The ambulance personnel's lived experience of older persons' participation includes passive and active dimensions and involves a balancing act between an exercise of power that impedes participation and equalisation of power that empowers participation. The main theme 'Balancing dignity in relation to manipulating the body' included the themes Providing a safe haven and Complying with bodily expressions, which means shouldering responsibility for existential well-being and being guided by reactions. The main theme 'Balancing influence in relation to perceived health risks' included the themes Agreeing on a common perspective, Directing decision-making mandate, and Sharing responsibility for well-being, which means shouldering responsibility for health focusing on risks. Influence is conditional and includes performance requirements for both the older person and municipal care personnel. CONCLUSION: Care-dependent older persons' participation in care from the perspective of ambulance personnel means recognising passive and active dimensions involving human dignity, the ability to influence care, and optimising care efforts through collaboration. This study provides a deepened understanding of the balancing of power involved in ambulance care determining participation, where power is equalised or exercised depending on personal engagement, health risks, and available care options. The knowledge provided holds the potential to improve ambulance care to benefit older persons in critical life situations.

How Have Physical Activity and Sedentary Behavior, Changed during the COVID-19 Pandemic? A Swedish Repeated Cross-Sectional Design Study.

Physical activity (PA) and sedentary behavior (SB) affect people's physical and mental health. The aim was to examine changes in PA and SB in a Swedish population: at three time points: 2019, 2020, and 2022, i.e., before and during the COVID-19 pandemic. Pre-pandemic PA and SB, i.e., 2019, were assessed retrospectively in 2020. Associations between PA and SB with sex, age, occupation, COVID-19 history, weight change, health, and life satisfaction were also examined. The design was repeated cross-sectionally. The main findings demonstrate the PA levels decreased between 2019 and 2020, and between 2019 and 2022, but not between 2020 and 2022. The SB increase was most evident between 2019 and 2020. Between 2020 and 2022, results showed a decrease in SB, but SB did not reach pre-pandemic levels. Both sexes decreased their PA over time. Although men reported more PA sex, they did not have any association with PA changes. Two age groups, 19-29 years and 65-79 years, decreased their PA over time. Both PA and SB were associated with COVID-19, occupation, age, life satisfaction, health, and weight change. This study underlines the importance of monitoring changes in PA and SB as they have relevance for health and well-being. There is a risk that the levels of PA and SB do not return to pre-pandemic levels in the population.

A matter of participation? A critical incident study of municipal care personnel in situations involving care-dependent older persons and emergency medical services.

PURPOSE: This study aimed at describing municipal care personnel's experiences of and actions in situations when older persons need emergency medical services (EMS) at home. METHODS: An inductive descriptive design adhering to critical incident technique (CIT) was used. Data were collected through interviews and free text written questionnaires, analysed in accordance with CIT procedure. RESULTS: Experiences related to the main areas of Lifesaving competence and Collaborative care. Lifesaving competence involved having sufficient knowledge to guide older persons in emergencies without organizational support. The lack of care alternatives carries dependence on inter-organizational collaboration, as well as having to accept the collaborative conditions provided by the EMS. Actions meant Adjusting to situational needs and EMS authority, which involved safeguarding the person while being directed by the EMS. CONCLUSIONS: Lack of organizational support, care alternatives, and structured collaboration jeopardize care-dependent older persons' health, and ability to influence care when emergency situations occur at home. Municipal care personnel's actions as the older person's representative support human agency, allowing older persons to become active participants in care despite acute suffering. This study underlines the importance of further developing welfare policies that facilitate and regulate inter-organizational responsibilities of health and social care to favour older people.

Changes in Physical Activity and Sedentary Behavior before and during the COVID-19 Pandemic: A Swedish Population Study.

Governments have enforced measures to limit the spread of COVID-19 with varying degrees of success, which could affect people's physical activity (PA) and sedentary behavior. This study aimed to examine changes in PA levels, types of PA, and sedentary behavior in the Swedish population before and during the COVID-19 pandemic. Associations between changed PA levels and demographical and behavioral determinants were also investigated. In December 2020, 1035 individuals (18-79 years old) completed a survey about their PA and sedentary behavior before and during the pandemic. Factors influencing their PA were also explored. Fifty-one percent of the sample reported reduced total PA, 18% had no change, and 31% increased their PA. Overall, organized PA decreased the most and sedentary behavior increased. The youngest and oldest age groups reported the greatest reduction in PA, while middle-aged groups reported the most increased PA. Men reported a larger increase in sedentary behavior than women. Mental and physical capability was associated with change in PA. In conclusion, this study indicates that, during the COVID-19 pandemic, the majority of the Swedish population have decreased PA levels with a concurrent increase in sedentary behavior, which may have negative health consequences. Interventions are recommended to address both PA and sedentary behavior, specifically to strengthen people's ability to perform PA and focusing on the youngest and oldest age groups.

An Overview of Guidelines for Supplemental Feeding of Infants in Swedish Maternity Clinics.

This study aims to describe the local guidelines for the supplemental feeding of infants of Swedish women's clinics with maternity wards. Purposeful sampling was used during a four-week data collection time in 2019. Guidelines from 41 of the 43 Swedish women's clinics with maternity wards were analysed using qualitative and quantitative content analysis. The information provided, and length of the guidelines varied widely in 38 guidelines. Feeding methods were included in 28 guidelines, but 10 provided no information about feeding methods. The most common feeding methods were cup feeding and feeding probes. Suggestions for supplemental feeding included infant formula (32), breast milk (27) and no suggestions (6). The methods to support breastfeeding were skin-to-skin contact (25), breastfeeding freely (22), a caring plan (18), extra supervision (3), optimising the caring environment (2), supplying a breast pump (1) and breastfeeding observation (1). Twenty-two guidelines included information about how long formula should be given and that the feeding should be phased out gradually. We conclude that a national guideline for the supplemental feeding of infants is needed to ensure equal best practice care for infant safety and the support of parents to increase the breastfeeding rate. More national guidelines are needed in general because it is easier to update only one set of guidelines.

Capturing the Unsaid: Nurses' Experiences of Identifying Mental Ill-Health in Older Men in Primary Care-A Qualitative Study of Narratives.

This study describes nurses' experiences in identifying mental ill-health in older men in primary care. The aging population is growing in Sweden and life expectancy is increasing. Age is a risk factor for mental ill-health. Older men are over-represented in deaths from suicide. When older men seek primary care, it is often because of somatic symptoms and rarely for mental health issues. A questionnaire with five open questions was answered by 39 nurses from 10 primary care centres and subjected to inductive qualitative content analysis. The results revealed a main theme-capturing the unsaid-and two categories: (1) feeling secure in the role, with three subcategories (building trust, daring to ask and interpreting signs); and (2) the need for resources, with two subcategories (time and continuity, and finding support in collaboration). The results confirm that nurses in primary care play a key role in identifying mental ill-health in older men. There is a need for resources in the form of time, competence and collaboration with other professionals and patients' relatives. This strategy will establish best practice and provide evidence-based care to facilitate improvements in older men's mental health and prevent suicide.

Changes in Mental Health and Views on Communication and Activities of Public Institutions among Swedes during the COVID-19 Pandemic-A Cross-Sectional Repeated Measures Design.

Although many studies have been conducted on the effects of COVID-19 on individual lives, only a few focus on the changes in mental health and views of public institutions during the pandemic. This study aimed to investigate how mental health, i.e., life satisfaction, worries, and psychological distress, and views on public institutions' communication and activities have changed among Swedes during the COVID-19 pandemic, and whether this was moderated by age and sex. In April-May 2020 (survey 1) and in January-February 2021 (survey 2), 2554 adults and 1904 newly recruited adults, respectively, anonymously completed online surveys. We found that life satisfaction and psychological distress did not change from survey 1 to survey 2. However, the level of worries increased, and the positive views of the public institutions decreased. Moreover, worries and psychological distress increased more in young adults than older adults. Finally, the change in the views of the public institutions was not related to the change in worries. Our results highlight the COVID-19 long-term impacts on individual mental health and call for the need for future research concerning the consequences for the population, especially among young adults. The results also indicate that the views on activities of public authorities decreased over time, especially among men. Given that loss of this trust can have vastly negative effects, for instance, on the vaccine campaign, it is important to monitor this trend, to increase awareness among Swedish authorities. The results also stress for institutions to provide adequate support both during the COVID-19 pandemic and in a future crisis.

Changes in Physical Activity Are Associated with Corresponding Changes in Psychological Well-Being: A Pandemic Case Study.

Societal crises and personal challenges are often followed by substantial changes in physical activity. Is there a link between such changes and psychological well-being? Seeking to answer this question, we conducted a correlational study on a representative sample in Sweden during the first year of the COVID-19 pandemic (N = 1035). About 49% of the sample had decreased their physical activity compared to their self-reported activity level prior to the pandemic, whereas 32% had increased it. The results showed a positive and robust association between changes in daily activity level and corresponding changes in psychological well-being. Specifically, individuals who had reduced their physical activity over the last year reported lower life satisfaction than before, and individuals who had increased their physical activity reported higher life satisfaction than before. The amount of complete physical inactivity (sitting) showed a similar pattern as the exercise data, meaning that individuals who reported increasing inactivity per day also reported a greater decline in life satisfaction. Additional analyses showed that the association between daily activity level and life satisfaction was somewhat stronger for men than for women, but there was no difference when comparing individual versus organized activities. The current study was based on a cross-sectional design, measuring self-reported change over time. Recent work from other research teams have used longitudinal data and experience-sampling in different settings, finding similar results. We conclude that there is good reason to recommend physical exercise as a coping strategy in difficult times.

Impacted family equality, self-confidence and loneliness: a cross-sectional study of first-time and multi-time fathers' satisfaction with prenatal and postnatal father groups in Sweden.

BACKGROUND: Fathers often feel secondary or invisible in traditional parent groups. Gender-specific parent groups, referred to as father groups, may be inclusive spaces for fathers to discuss their transition into parenthood. OBJECTIVE: To quantitatively assess fathers' perceptions and satisfaction of father groups in Sweden during the prenatal and postnatal periods. METHOD: A cross-sectional quantitative study design was used to report fathers' satisfaction of father groups, including how the groups impacted their personal outcomes, as well as their relationship with their partner and child. Further analyses were completed on if their depressive symptoms, via EPDS, and/or parity affected their satisfaction and personal outcomes. SETTING AND PARTICIPANTS: Fathers were recruited through father group leaders, who then provided the researchers with their contact information. In total, 87 fathers were contacted via email and 67 fathers from two geographical areas, including urban and suburban settings, completed the survey. FINDINGS: Most fathers had a university education, a good household economy and were married/cohabiting, while almost 60% were first-time fathers and almost 25% had depressive symptoms. Overall, fathers were generally satisfied with both the prenatal and postnatal father groups, although fathers attended prenatal father groups to a lesser extent. The participants rated the father groups as moderately impacting their equality in the family, self-confidence, feelings of loneliness, social network and being able to express their own opinions, as well as positively affected their relationship with their partner and child, respectively. While there were no differences based on fathers' parity, those who self-estimated depressive symptoms were less satisfied and rated the father groups less impactfully. Father groups may help encourage fathers to meet policy goals, such as childrearing equality, and can be an important arena for screening fathers for depression.

Characteristic patterns of emergency ambulance assignments for older adults compared with adults requiring emergency care at home in Sweden: a total population study.

BACKGROUND: Since the vast majority of older adults in Sweden live in their private homes throughout life, the emergency medical services need to adapt accordingly. Hence, we aimed to describe characteristic patterns of dyadic staffed emergency ambulance assignments for older adults aged > 70 years compared with adults aged 18-69 years requiring emergency care at home in Sweden. METHODS: A descriptive retrospective study was performed using anonymized registry data from the emergency medical services in a region of Sweden during 2017-2018. One-sample χ2 test, one-way analysis of variance, and binary logistic regression models were used for investigating group differences. Variables for analysis were age, gender, clinical assessments, on-scene time, priority levels, result of response, and temporal patterns. RESULTS: Of all included emergency ambulance assignments (n = 28,533), 59.9% involved older adults, of which 53.8% were women. The probability for older adults to receive the highest priority was decreased for both dispatch (p < 0.001, odds ratio [OR] 0.63, 95% confidence interval [CI] 0.59-0.66), and transport priorities (p < 0.001, OR 0.74, 95% CI 0.68-0.80). Older adults were more likely to receive dispatch priority levels 2 (p < 0.001, OR 1.48, 95% CI 1.40-1.56), and 3 (p < 0.001, OR 1.73, 95% CI 1.46-2.06). The older adults were similarly more likely to receive transport priority level 3 (p < 0.001, OR 1.40, 95% CI 1.28-1.52) compared with adults. Age had a small but additive effect in relation to on-scene time (p < 0.001, R2 = 0.01, F = 53.82). Distinguishing initial clinical assessments for older adults were circulatory, respiratory, trauma, infection, and nonspecific assessments. Emergency ambulance assignments for older adults were more frequently occurring on Mondays (p < 0.001, χ2 = 232.56), and in the 08:00-11:59 interval (p < 0.001, χ2 = 1224.08). CONCLUSION: The issues of the lower priority level preponderance, and the decreased probability for receiving the highest priority warrant further attention in future research and clinical practice.

When Life Ceases-Relatives' Experiences When a Family Member Is Confirmed Brain Dead and Becomes a Potential Organ Donor-A Literature Review.

INTRODUCTION: Most healthcare professionals rarely experience situations of a request for organ donation being made to the patient's family and need to have knowledge and understanding of the relatives' experiences. OBJECTIVE: To describe relatives' experiences when a family member is confirmed brain dead and becomes a potential organ donor. METHODS: A literature review and a thematic data analysis were undertaken, guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting process. A total of 18 papers, 15 qualitative and 3 quantitative, published from 2010 to 2019, were included. The electronic search was carried out in January 2019. RESULTS: The overarching theme When life ceases emerged as a description of relatives' experiences during the donation process, including five subthemes: cognitive dissonance and becoming overwhelmed with emotions, interacting with healthcare professionals, being in a complex decision-making process, the need for proximity and privacy, and feeling hope for the future. The relatives had different needs during the donation process. They were often in shock when the declaration of brain death was presented, and the donation request was made, which affected their ability to assimilate and understand information. They had difficulty understanding the concept of brain death. The healthcare professionals caring for the patient had an impact on how the relatives felt after the donation process. Furthermore, relatives needed follow-up to process their loss. CONCLUSION: Caring science with an explicit relative perspective during the donor process is limited. The grief process is individual for every relative, as the donation process affects relatives' processing of their loss. We assert that intensive care unit nurses should be included when essential information is given, as they often work closest to the patient and her or his family. Furthermore, the relatives need to be followed up afterwards, in order to have questions answered and to process the grief, together with healthcare professionals who have insight into the hospital stay and the donation process.

Anaesthetizing children-From a nurse anaesthetist's perspective-A qualitative study.

AIM: The aim of this study was to describe nurse anaesthetists' experiences of encountering and caring for children in connection to anaesthesia. DESIGN: Qualitative design. METHODS: Sixteen written narratives based on eight nurse anaesthetists' experiences of meeting children was analysed using qualitative content analysis. RESULTS: The overarching theme was: "anaesthetizing children is a complex caring situation, including interactions with the child and parents as well as ensuring patient safety, affected by the perioperative team and organizational prerequisites". The nurses stated that in their interaction with the family, their goal was to ensure that children and parents felt secure and calm. "Striving to work in confidence" underlined the team and organizational influences. Encountering children involves more than knowledge about technical equipment, procedures and drugs. Knowledge about children's development and fears and parents' needs are essential for an optimal caring situation. Organizations need to realize that extra time, skills and resources are needed to safely anaesthetize children.

More secure attachment to the father and the mother is associated with fewer depressive symptoms in adolescents.

AIM: To investigate whether more secure attachment to the father and the mother is associated with less depressive symptoms among adolescents, and to explore possible sex differences. METHOD: A population-based sample of adolescents completed a school-based survey assessing demographic data, attachment to father and mother, as well as depressive symptoms. Participation rate was 80% of the eligible population, and 3,988 adolescents (1,937 boys and 2,051 girls) had complete data for the analyses. RESULTS: Paired samples t tests showed that participants rated their attachment to mothers as slightly more secure than their attachment to fathers (t = 15.94, P < 0.001; boys: t = 5.23, P < 0.001; girls: t = 16.16, P < 0.001). In linear regression analyses there was an association between the outcome, number of depressive symptoms, and more secure attachment to the mother for boys (B = -0.532; 95% confidence interval [CI] -0.656, -0.407, P < 0.001) and for girls (B = -0.623; 95% CI -0.730, -0.516, P < 0.001). Analogous results were found for more secure attachment to the father for boys (B = -0.499; 95% CI -0.608, -0.391, P < 0.001) and for girls (B = -0.494; 95% CI -0.586, -0.401, P < 0.001). CONCLUSIONS: Understanding the relationship between attachment to both father and mother and depressive symptoms in adolescent boys and girls is essential for further development of strategies for prevention and treatment of depression.

Father group leaders' experiences of creating an arena for father support - A qualitative study.

BACKGROUND: Parental classes consisting of only fathers, hereafter referred to as father groups, have existed in Sweden since the mid-1990s. OBJECTIVE: To describe the father group leaders' perspectives on and experiences of father groups. METHOD: A qualitative study was conducted using content analysis. Eleven individual interviews with father group leaders were conducted. An interview guide was used. SETTINGS AND PARTICIPANTS: The study was set in different parts of Sweden. The participants were eleven men who are father group leaders. They were recruited using the snowball method. FINDINGS: The father group leaders described how participants often have high education levels and orderly social circumstances. The leaders described that the groups increased the fathers' reflection about parenthood, which could benefit the whole family in both the short and long term. The father group leaders reported that some of the topics in the sessions directly influenced fathers to discuss issues regarding equality and their co-parenting relationship. They also argued that participating in father groups might help convince fathers to take more parental leave and build stronger relationships with their partner and child.

Association between depressive symptoms and parental stress among mothers and fathers in early parenthood: A Swedish cohort study.

Aim To determine whether there is an association between depressive symptoms and parental stress among mothers and fathers during early parenthood in Sweden. Methods In this study, 401 mothers and 396 fathers (393 couples) were included; the Edinburgh Postnatal Depression Scale and the Sense of Coherence Scale were measured 3 months after childbirth, and the Swedish Parenthood Stress Questionnaire and the Sense of Coherence Scale after 18 months. Complete data for multivariable analysis were available for 264 mothers and 252 fathers. Results The mothers estimated greater total depressive symptoms and parental stress than the fathers did. Both the mothers and the fathers had the greatest level of stress in the sub-area 'Role restriction'. The mothers had the lowest level of stress in the sub-area 'Social isolation' and the fathers in the sub-area 'Incompetence'. The mothers perceived greater levels of stress than the fathers did in all sub-areas except for 'Social isolation', where the fathers perceived higher stress. There was an association between the parents' depressive symptoms and parental stress. The parents' own depressive symptoms at 3 months and sense of coherence and the partners' parental stress at 18 months were positively associated with the parental stress at 18 months in univariable and multivariable analyses. Conclusions Understanding the relationship between depressive symptoms and parental stress is important for health professionals so they can offer parents adequate support in early parenthood to optimize the conditions for raising a child. This knowledge should also be communicated to the parents.

Association between parental depressive symptoms and impaired bonding with the infant.

Impaired bonding with the infant is associated with maternal postpartum depression but has not been investigated extensively in fathers. The primary study aim was to evaluate associations between maternal and paternal depressive symptoms and impaired bonding with their infant. A secondary aim was to determine the associations between parents' marital problems and impaired bonding with the infant. The study is part of a population-based cohort project (UPPSAT) in Uppsala, Sweden. The Edinburgh Postnatal Depression Scale (EPDS) at 6 weeks and 6 months postpartum and the Postpartum Bonding Questionnaire at 6 months postpartum were completed by 727 couples. The prevalence of impaired bonding was highest among couples in which both spouses had depressive symptoms. Impaired bonding was associated with higher EPDS scores in both mothers and fathers, as well as with experiencing a deteriorated marital relationship. The association between maternal and paternal impaired bonding and the mothers' and fathers' EPDS scores remained significant even after adjustment for relevant confounding factors. Depressive symptoms at 6 weeks postpartum are associated with impaired bonding with the infant at 6 months postpartum for both mothers and fathers. It is critical to screen for and prevent depressive symptoms in both parents during early parenthood.

Depressive symptoms postpartum among parents are associated with marital separation: a Swedish cohort study.

AIMS: To study whether there is an association between dyadic consensus, depressive symptoms, and parental stress during early parenthood and marital separation 6-8 years after childbirth, among couples in Sweden. METHODS: At baseline, 393 couples were included. The couples answered three questionnaires, including: Dyadic consensus at 1 week post-partum, depressive symptoms at 3 months post-partum and parental stress at 18 months post-partum. The parents' addresses were followed up after 6-8 years, to study the marital separation rate. RESULTS: We found, 6-8 years after childbirth, that 20% of study couples were separated. Separation was associated with less dyadic consensus (mothers p < 0.001; fathers p < 0.001), depressive symptoms (mothers p = 0.022; fathers p = 0.041) and parental stress (mothers p = 0.002; fathers p = 0.040). The hazard ratio (HR) for marital separation was related to dyadic consensus for fathers (HR 0.51; 95% CI 0.28-0.92), depressive symptoms for mothers (HR 1.69; 95% CI 1.01-2.84) and fathers (HR 1.92; 95% CI 1.12-3.28), and the mother's parental stress (HR 2.16; 95% CI 1.14-4.07). CONCLUSIONS: Understanding how dyadic consensus, depressive symptoms and parental stress are associated with marital separation is important for health professionals it could be useful in developing interventions to provide parents with adequate support during pregnancy and early parenthood this knowledge is also important for the public parents should get support in pregnancy and while bringing up children, which may help prevent marital separation and optimize conditions for the children.