HED-Start: A Brief Positive Psychology Cluster-Randomized Controlled Trial to Improve Psychological Adjustment in Patients New on Hemodialysis.

This article focuses on evaluating the effectiveness of HED-Start, a brief positive psychology intervention designed to improve psychological adjustment in patients newly initiated on hemodialysis (HD). Conducted as a cluster-randomized controlled trial at National Kidney Foundation Singapore dialysis centers, the intervention comprised four group sessions emphasizing positive emotions, acceptance, and life-oriented goal setting, delivered by trained healthcare staff. Results from 147 participants showed that HED-Start significantly reduced depressive symptoms and rates of clinical depression while improving quality of life, self-efficacy, benefit finding, and self-management skills compared to usual care, with moderate effect sizes. The study suggests that low-intensity, positive-skills programs like HED-Start can be a feasible and valuable adjunct to renal care services, though further research is needed to confirm long-term benefits and applicability in diverse populations.