{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T05:52:04Z","timestamp":1775454724158,"version":"3.50.1"},"reference-count":51,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,4,4]],"date-time":"2026-04-04T00:00:00Z","timestamp":1775260800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Chronic kidney disease (CKD) is an increasingly important global health challenge and is frequently accompanied by psychiatric symptoms, including anxiety. A multidimensional assessment of anxiety in hemodialysis (HD) using the Endler Multidimensional Anxiety Scales (EMAS) has not, to our knowledge, been previously reported. We aim to evaluate the reliability, convergent validity, and exploratory domain-level structure of EMAS in HD patients treated at a dialysis center in Craiova, Romania. Materials and Methods: A total of 103 HD patients underwent clinical and sociodemographic\/socioeconomic profiling, cognitive screening using the Mini-Mental State Examination (MMSE), and EMAS administration at two time points (4-week interval) for test\u2013retest evaluation. The anxiety subscale of the Depression, Anxiety, and Stress Scale-21R (DASS-21R) was administered to assess convergent validity. Internal consistency (Cronbach\u2019s \u03b1), temporal stability (test\u2013retest correlations and intraclass correlation coefficients), and convergent validity (Pearson correlations) were computed. Exploratory factor analyses were conducted on EMAS domain scores (state, trait, and perceived anxiety domains) as an exploratory structural check. Results: EMAS state and trait anxiety scores were higher in women than in men, while perceived anxiety showed a more heterogeneous pattern across dimensions. Total state anxiety increased with age, particularly after 50 years. Domain-level internal consistency was good for state and acceptable for trait components (standardized \u03b1 \u2248 0.84 and 0.78 across administrations), whereas perceived anxiety domains showed low cross-domain coherence, consistent with context-specific appraisal. The DASS-21R anxiety subscale showed good internal consistency (\u03b1 = 0.863). Convergent validity analyses indicated small, domain-specific associations between EMAS scores and DASS-21R anxiety. Domain-level EFA supported a theoretically coherent pattern in which state and trait domains clustered distinctly, while perceived anxiety domains formed a partially separable factor; this pattern was broadly consistent across both administrations. Conclusions: In this HD cohort, EMAS demonstrated good reliability and limited but domain-specific evidence of convergent validity, and exploratory domain-level analyses supported its multidimensional organization. Further studies with larger samples are warranted for item-level structural testing and to inform feasibility-oriented shortening for potential clinical use.<\/jats:p>","DOI":"10.3390\/medicina62040694","type":"journal-article","created":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T04:10:27Z","timestamp":1775448627000},"page":"694","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Exploratory Psychometric Assessment of the Endler Multidimensional Anxiety Scales in Romanian Hemodialysis Patients: Reliability, Convergent Validity, and Domain-Level Structure"],"prefix":"10.3390","volume":"62","author":[{"given":"Adriana-Luciana","family":"Luca","sequence":"first","affiliation":[{"name":"U.M.F. Doctoral School Craiova, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Felicia","family":"Militaru","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9028-7583","authenticated-orcid":false,"given":"Virginia Maria","family":"R\u0103dulescu","sequence":"additional","affiliation":[{"name":"Department of Medical Informatics and Biostatistics, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristina Mariana","family":"V\u0103duva","sequence":"additional","affiliation":[{"name":"Hemodialysis Center, Emergency County Hospital of Craiova, 200642 Craiova, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-3410-1334","authenticated-orcid":false,"given":"Daniela Teodora","family":"Maria","sequence":"additional","affiliation":[{"name":"Department of Nephrology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M\u0103d\u0103lina Iuliana","family":"Mu\u0219at","sequence":"additional","affiliation":[{"name":"Experimental Research Centre for Normal and Pathological Aging, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"},{"name":"Department of Scientific Research Methodology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-9261-8496","authenticated-orcid":false,"given":"Ion","family":"Udri\u0219toiu","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eugen","family":"Mo\u021ba","sequence":"additional","affiliation":[{"name":"U.M.F. Doctoral School Craiova, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Elezi, B., Abazaj, E., Zappacosta, B., and Hoxha, M. (2023). Anxiety and depression in geriatric hemodialysis patients: Factors that influence the border of diseases. Front. Psychol., 14.","DOI":"10.3389\/fpsyg.2023.1281878"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2905","DOI":"10.1007\/s11255-023-03556-7","article-title":"Anxiety and depression in maintenance hemodialysis patients: Prevalence and their effects on health-related quality of life","volume":"55","author":"Nagy","year":"2023","journal-title":"Int. Urol. 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