The relationship sabotage scale: an evaluation of factor analyses and constructive validity.

BACKGROUND: Some individuals are no longer entering romantic relationships, others move through relationships too quickly searching for "the one" and making quick assessments of their romantic partners, while others stay in their relationships but "check out" or do not work on their issues. These are conclusions from two studies: (1) an interview with psychologists who specialise in relationship therapy, and (2) an analysis of individuals' lived experiences of relationships. The concept of relationship sabotage can explain these phenomena. However, presently, there is no instrument to conceptualise and empirically measure how people continue to employ self-defeating attitudes and behaviors in (and out) of relationships to impede success, or withdraw effort, and justify failure. METHODS AND RESULTS: A series of three studies (involving a total of 1365 English speaking individuals of diverse gender orientation, sexual orientation, and cultural background, with relationship sabotage experience) were conceptualized for the current project to fill the need for scale development and to build empirical evidence on the topic of self-sabotage in romantic relationships. The scale was developed over two studies using exploratory factor analysis and one-congeneric model analyses. The third study, using confirmatory factor analysis, confirmed the final structure for the Relationship Sabotage Scale (RSS), which contains 12 items and three factors: defensiveness, trust difficulty, and lack of relationship skills. Constructive validity analyses were also conducted. CONCLUSION: The RSS is a brief scale that provides conclusive information about individual patterns in relationships. Findings using this scale can offer explanations regarding the reasons that individuals engage in destructive behaviours from one relationship to the next. Investigations should continue to test a model for sabotage in romantic relationships using the developed scale and other factors such as relationship diferences and insecure attachment. More specifically, this measure can be used to understand mediator constructs of relational outcomes within the attachment framework to explain relationship dissolution and work towards relationship maintenance.

The impact of localised general practice training on Queensland's rural and remote general practice workforce.

BACKGROUND: The diverse rural medical education initiatives that have been developed in Australia to address the medical workforce maldistribution have been less successful in many smaller and remote communities. This study explored the factors that attract and retain GP registrars and supervisors and the impact that localised training (i.e., rural and remote workplace-based training and support) has on both GP registrars and supervisors, and the GP workforce in rural and remote underserved areas. METHODS: A purposive sample of 79 GP registrars, supervisors, practice managers, health services staff and community representatives living and working in areas of low GP workforce in rural and remote Australia were invited to participate in semi-structured interviews and one focus group divided over two phases. Thematic analysis was used to explore themes within the data. FINDINGS: Attractors and barriers to rural and remote practice were identified as the main themes. Attractors include family and community lifestyle factors, individual intrinsic motivators, and remote medicine experiences. In contrast, barriers include work related, location, or family factors. Further, localised GP training was reported to specifically influence GP registrars and supervisors through education, social and financial factors. CONCLUSION: The current study has provided a contemporary overview of the issues encountered in expanding GP training capacity in rural and remote communities to improve the alignment of training opportunities with community and workforce needs. Strategies including matching scope of practice to registrar interests have been implemented to promote the attractors and lessen the barriers associated with rural and remote practice.

Building general practice training capacity in rural and remote Australia with underserved primary care services: a qualitative investigation.

BACKGROUND: Australians living in rural and remote areas have access to considerably fewer doctors compared with populations in major cities. Despite plentiful, descriptive data about what attracts and retains doctors to rural practice, more evidence is needed which informs actions to address these issues, particularly in remote areas. This study aimed to explore the factors influencing General Practitioners (GPs), primary care doctors, and those training to become GPs (registrars) to work and train in remote underserved towns to inform the building of primary care training capacity in areas needing more primary care services (and GP training opportunities) to support their population's health needs. METHODS: A qualitative approach was adopted involving a series of 39 semi-structured interviews of a purposeful sample of 14 registrars, 12 supervisors, and 13 practice managers. Fifteen Australian Medical Graduates (AMG) and eleven International Medical Graduates (IMG), who did their basic medical training in another country, were among the interviewees. Data underwent thematic analysis. RESULTS: Four main themes were identified including 1) supervised learning in underserved communities, 2) impact of working in small, remote contexts, 3) work-life balance, and 4) fostering sustainable remote practice. Overall, the findings suggested that remote GP training provides extensive and safe registrar learning opportunities and supervision is generally of high quality. Supervisors also expressed a desire for more upskilling and professional development to support their retention in the community as they reach mid-career. Registrars enjoyed the challenge of remote medical practice with opportunities to work at the top of their scope of practice with excellent clinical role models, and in a setting where they can make a difference. Remote underserved communities contribute to attracting and retaining their GP workforce by integrating registrars and supervisors into the local community and ensuring sustainable work-life practice models for their doctors. CONCLUSIONS: This study provides important new evidence to support development of high-quality GP training and supervision in remote contexts where there is a need for more GPs to provide primary care services for the population.