Although this app intervention has the potential to reduce depressive symptoms, the app needs to be improved to increase adherence rates.

To confirm that the change was not a result of measurement error, a score of self-reported outcome measurement scales would need to change by an amount greater than these SDC values. This has important implications for clinicians and epidemiologists when assessing outcomes.

No abstract

This study was performed to investigate the relationship between mental state (especially flow experience [Flow Experience Checklist of Ishimura]) health-related quality of life (Medical Outcome Study 8-Item Short-Form Health Survey), and stress (salivary amylase concentrations). The subjects were 119 healthy elderly persons living in rural areas who participated in a "meeting for the elderly" at a nursing home in Kagawa Prefecture, Japan. The subjects were classified into apathetic, anxious, relaxed, and flow groups. It was found that physical health was significantly better when performing important daily activities in the group who experienced flow and the relaxed group than in the group that was in an apathetic state. However, no significant relationship was observed between the degree of flow experience and stress. The present findings suggested that interventions which make the activities of daily life either "high-challenge, high-skill" situations or "low-challenge, high-skill" situations could have a positive influence on the physical health of community-living elderly Japanese. A longitudinal study should be performed in the future.

Assessment and adjustment of the challenge-skill balance of activities may effectively improve older adults' HRQOL.