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Promotion of reduction of alcohol intake in chronic liver disease patient on ultrasound department Situation The effects of alcohol to the liver are well known since the organ liver is responsible for metabolising it. Liver is a strong complex organ and has the ability to remove the toxic substance in alcohol by a process called oxidation. However, prolonged alcohol intake could lead to damage in liver cells due to the metabolic by-products formed during metabolism, resulting to three stages of liver conditions: steatosis, alcoholic hepatitis and cirrhosis (Neuberger & Dimartini, 2015).

Scotland ranks as one of the highest mortality rates in Europe in chronic liver disease. The cause of loss and grief in someone beloved is highly related to alcohol abuse leading to chronic liver disease. Alcohol related harm in Soottish population costing around 3.5 billion each year according to the Scottish government statistics estimate The Scottish government, 2013)

According to the Daily Record newspaper (2015). chronic liver disease is increasing across Scotland The highest number of people staying in hospital related to chronic liver disease was documented in 2014, which is from 47 in 1982 to 190 in 2014 per one hundred thousand populations (BBC news, 2013) described the death rate from chronic liver disease in Scotland is 70% higher than 7e across UK and 30% higher than 30 years. ago Excessive consumption of alconol the prime cause of chronic Iver disease which mocounas bo 20% 01 the connitic The disease tends to affect men more than double comparing to women.

Utilising the theory from NHS Lothian (2015) that "every health care contact is a health improvement opportunity" as an initiate, equally diagnostic radiographers have a duty of care to provide health information and advice to patients that could influence change for better quality of life. Therefore I have identified ultrasound department as a suitable place for health promotion opportunity to radiographers to influence chronic liver patients by setting alcohol reducing interventional technique.

Aim

The ultimate aim of the intervention is to assess patients with alcohol related liver disease on ultrasound department and make long term changes in their drinking habits by introducing alcohol reducing practice.

Intervention

Motivational based intervention technique will be used to influence patient to increase awareness towards alcohol. Carlo et al 1999) described motivation as an important first step toward any action or change in behaviour The intervention will focus in encouraging patients to change their behaviour towards alcohol consumption in order to improve their current health problem (Gramenzi et al. 2006).

· Target group : The intervention will be delivered to men who are experiencing significant alcohol related liver harms.

· Design : The intervention is designed to influence individuals to make rapid behavioural change and help them leam coping skills to take control of alcohol habits. The intervention will include one to one healthy conversation The term healthy conversation described by the royal society for public health (2015) as an opportunity for health professionals to encourage clients (patients) to consider their life style and make vital changes and afterwards handing them information package related to alcohol.

One to one motivational debriefing will be delivered for the length period of time between 5 to 10 minutes. This will include discussion how clients are dealing with alcohol explaining the disadvantage of alcohol drinks, giving them the best advice how they could minimise excessive consumption of alcohol, finally providing them a package of booklet and important contact numbers of organisations whom can help individuals with alcohol related problems, Tones and Tilford (2001) in their book survey states that people want information across health areas

· Setting Ultrasound imaging is currently providing important role in the detection and management of chronic liver disease Ultrasound has an advantage of using non-invasive technique on measurement of chronic liver disease and is gradually replacing clinical management of liver disease such as biopsy (Gerstenmaier & Gibson, 2014).

The intervention will be delivered in the ultrasound department rooms as the private setting of ultrasound room is suitable for one to one discussion, and this will be a good opportunity for sonographers to deliver health advice to their patients after each examination (United Kingdom association of sonographers, 2008).

· Outcome Alcohol related liver damage expected to decrease after patient's behavioural lifestyle approach to drinking was monitored and individuals will benefit from the intervention by preventing further damage to their liver before it becomes irreversible (Pinzani et al, 2011). The impact of alcohol abuse causes enormous problems on individual's budget, employment and social life's therefore avoiding those all social problems are the most and important value of the intervention on individuals and also on the wider communities (Ewles, 2005).

Passible challenges of the intervention; Being an alcohol dependency is a behavioural disorder and changing addictive behaviour is time consuming (Naidoo & Wills, 2009). it also has cha yes to co vinca individuals to stop from their drinking habits Patients may show resistance to engage on behaviour change conversation; simply they may not ready to change for many personal reasons and this sometimes create conflict between the health professional (sonographers) and the patient (Miller & Rollnick, 1991). Other challenges may exist that could halt patient's intervention programme such as peer pressure, unstable home environment and copying from parents eman, 2001).

Nevertheless the health professionals have the power to influence the outcome of the intervention for better or worse so that lack of behaviour change is not only the patient's problem: it is also shortage of the knowledge of the health professionals approach to the patient as well. However, patients are more liable to change their health behaviour if "a life-threatening or medical event occurs in their life (Manson & Butler, 2010)

· To conclude my report, planning behavioural approach to clients (alcohol related inver disease patients) has the advantage of enabling individuals to develop their knowledge towards alcohol and its consequences, and also helps to change their attitudes towards excessive drinking Sonographers should have the skills to help individuals to identify the health issue of aloohol even though the process takes time and patience to convince people.