Background/Aims: Mothers of children with very-early-onset inflammatory bowel disease (VEO-IBD) face unique challenges; however, these challenges and their consequences have not been well described. This study clarified the experiences and processes of empowerment of mothers of children with VEO-IBD. Methods: This study performed a qualitative inductive analysis using semi-structured interviews. The interview content was transcribed, generating core categories, categories, and subcategories with a focus on mothers raising children with VEO-IBD. A modified grounded theory approach was employed to inductively construct a theory from the qualitative data. Results: Fifteen mothers of children with VEO-IBD were interviewed (mean age, 43.9 ± 6.2 years). The modified grounded theory approach revealed the processes experienced by the mothers. The mothers faced various difficulties when their children developed VEO-IBD; however, their efforts to cope with these difficulties changed their situation. Furthermore, they were supported by various individuals, including family members, medical personnel, and, occasionally, families of other children with VEO-IBD. These processes strengthened and empowered the mothers. Conclusions Mothers of children with VEO-IBD who faced various difficulties were empowered through their efforts and support from family and others who understood their challenges. This process of empowerment continues throughout the development of children with VEO-IBD.

Purpose: The parents of adolescents with inflammatory bowel disease may experience impaired mental health and quality of life. This longitudinal study aimed to verify whether the mental health and quality of life of the parents of adolescents with inflammatory bowel disease declined when their children had active disease. Methods: Sociodemographic data, parental anxiety, depression, and quality of life were analyzed using validated questionnaires for each variable. After the baseline survey, the second and follow-up surveys were conducted at 3 and 12 months, respectively. The active disease group comprised eight parents whose children had active disease during the baseline and second surveys. The remission group comprised 14 parents whose children remained in remission during both surveys. The improved group comprised nine parents whose children experienced active disease at baseline and remission during the second survey. Parental mental health and quality of life were compared among the groups. Results: Significantly higher levels of anxiety were observed in the active disease group in all surveys (p<0.050). Although depression levels and quality of life did not differ significantly among the three groups, pairing the active disease group with other groups showed some large effect sizes. Conclusion Parents tended to experience decreased mental health and quality of life when their adolescents experienced active inflammatory bowel disease. Consequently, our hypothesis was partially verified. Therefore, parents need support when their children have active disease; this finding highlights the need for parental support systems.

Objective: Distigmine can cause cholinergic crisis as the side effect.  In 2010, the safety information of distigmine was announced and its dosage was changed up to 5 mg per day.  However, the malpractice that a pharmacist dispensed over dose of distigmine caused severe health damages in a community pharmacy.  Therefore, we made the protocol with the urologists for the appropriate use of distigmine, including contents of monitoring the side effects.  The purpose of this study was to measure using the protocol was useful for the propulsion of proper use of distigmine.
Methods: The protocol was introduced in 10 community pharmacies and 1 hospital pharmacy from December 2013 to April 2014, and the patients and pharmacists were filled out the answer to the questions that we have made.  The protocol consisted of five main checks; the dosage, lower urinary tract symptom, presence of renal disease, combined drugs, and signs of the side effects.  Each patient was filled out the checklist given by the pharmacist to monitor the signs of the side effects for 2 weeks.
Results: The 3 prescriptions of distigmine (18.8%) were more than 10 mg per day.  Although 2 patients were confirmed diarrhea and sweating etc., they were mild.  The pharmacists significantly more (p<0.05) answered that the protocol made their motivation to do the pharmaceutical interventions.  All of the patients answered that the pharmaceutical interventions made them relieved.
Conclusion: The use of protocol that we made supported pharmacists to do the pharmaceutical interventions and patients welcome them.