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dc.contributor.authorGriva, Konstadinaen_US
dc.contributor.authorChia, Jace Ming Xuanen_US
dc.contributor.authorGoh, Zack Zhong Shengen_US
dc.contributor.authorWong, Yen Pengen_US
dc.contributor.authorLoei, Joben_US
dc.contributor.authorThach, Thuan Quocen_US
dc.contributor.authorChua, Wei Binen_US
dc.contributor.authorKhan, Behram A.en_US
dc.identifier.citationGriva, K., Chia, J. M. X., Goh, Z. Z. S., Wong, Y. P., Loei, J., Thach, T. Q., Chua, W. B. & Khan, B. A. (2021). Effectiveness of a brief positive skills intervention to improve psychological adjustment in patients with end-stage kidney disease newly initiated on haemodialysis : protocol for a randomised controlled trial (HED-Start). BMJ Open, 11(9), e053588-.
dc.description.abstractIntroduction Initiation onto haemodialysis is a critical transition that entails multiple psychosocial and behavioural demands that can compound mental health burden. Interventions guided by self-management and cognitive-behavioural therapy to improve distress have been variably effective yet are resource-intensive or delivered reactively. Interventions with a focus on positive affect for patients with end-stage kidney disease are lacking. This study will seek (1) to develop a positive life skills intervention (HED-Start) combining evidence and stakeholder/user involvement and (2) evaluate the effectiveness of HED-Start to facilitate positive life skills acquisition and improve symptoms of distress and adjustment in incident haemodialysis patients. Methods and analysis This is a single/assessor-blinded randomised controlled trial (RCT) to compare HED-Start to usual care. In designing HED-Start, semistructured interviews, a codesign workshop and an internal pilot will be undertaken, followed by a two-arm parallel RCT to evaluate the effectiveness of HED-Start. A total of 148 incident HD patients will be randomised using a 1:2 ratio into usual care versus HED-Start to be delivered in groups by trained facilitators between January 2021 and September 2022. Anxiety and depression will be the primary outcomes; secondary outcomes will be positive and negative affect, quality of life, illness perceptions, self-efficacy, self-management skills, benefit finding and resilience. Assessments will be taken at 2 weeks prerandomisation (baseline) and 3 months postrandomisation (2 weeks post-HED-Start completion). Primary analyses will use an intention-to-treat approach and compare changes in outcomes from baseline to follow-up relative to the control group using mixed-effect models. Ethics and dissemination Ethics approval was obtained from Nanyang Technological University Institutional Review Board (IRB-2019-01-010). Written informed consent will be obtained before any research activities. Trial results will be disseminated via publications in peer-reviewed journals and conference presentations and will inform revision(s) in renal health services to support the transition of new patients to haemodialysis. Trial registration number NCT04774770.en_US
dc.relation.ispartofBMJ Openen_US
dc.rights© 2021 The Author(s) (or their employer(s)). Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.s This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work noncommercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: licenses/by-nc/4.0/.en_US
dc.titleEffectiveness of a brief positive skills intervention to improve psychological adjustment in patients with end-stage kidney disease newly initiated on haemodialysis : protocol for a randomised controlled trial (HED-Start)en_US
dc.typeJournal Articleen
dc.contributor.schoolLee Kong Chian School of Medicine (LKCMedicine)en_US
dc.description.versionPublished versionen_US
dc.subject.keywordsEnd Stage Renal Failureen_US
dc.description.acknowledgementThis research is supported by the National Kidney Foundation Singapore under its Venerable Yen Pei-NKF Research Fund (NKFRC/2018/01/02). NKF Singapore provided the patients and venue for the HED-Start intervention sessions.en_US
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