Thesis M. A. (Psychology) -- University of Limpopo, 2019 / The CVA patients normally do not know what to expect and often get confused by the change of behaviour that may result. This is because little is done on informing them of the risk factors, the stigma attached to CVAs, and also some strategies on how to deal with all the experiences CVAs bring along with them. The main aim of this study was to inquire more about the lived experiences of people with cerebrovascular accidents in Ga-Dikgale, Limpopo Province. Ten people living with CVAs’ in Ga-Dikgale village, in the Capricorn district, were selected and interviewed. The interviews were audio-taped, and later transcribed and translated. The original data was reduced and interrogated to identify some emerging meaning units which further led to emergence of themes. Phenomenology and the health belief model were chosen as the relevant lenses with which the study could be viewed. Phenomenology helps understand the individual from his or her point of view while the health belief model describes how a person’s belief towards his or her health status can affect their healing process, and these are lens with which to view this study. Snowball and purposive sampling methods were used for sampling participants and data was collected through semi-structured face- to-face interviews. IPA was used for analysing collected data in this study. Most participants in this study were found to still believe that CVAs are a result of witchcraft, while ignoring the main risk factors such as hypertension, high blood pressure and diabetes, to mention a few. The study also study revealed the daily experiences of living with CVAs. It is not an easy thing for others as they have to endure a lot of pain and also the embarrassment of being unable to control their bodies and emotions. / National Research Foundation (NRF)

Diss. (sammanfattning) Göteborg : Univ., 2008. / Härtill 5 uppsatser.

Background: Despite the successful development in cardiac surgery, cerebrovascular accidents (CVA) remain a devastating complication. Aortic atherosclerosis has been identified as a major risk factor for CVA. The present thesis addresses this question in relation to aortic manipulation during cardiac surgery, being divided into a clinical (I-II) and an experimental part (III-V). Material and methods: Consecutive cardiac surgery cases (n=2641) were analyzed. Patients with CVA were extracted from a database designed to monitor clinical symptoms. Patient records were used to confirm clinical data and diagnosis. Subdivision was made into three groups: control subjects, immediate, and delayed CVA, being analyzed for neurological symptoms (I). Patients with CVA who also had been investigated with computer tomography (CT) (n=77) were further evaluated in terms of hemispheric and vascular distribution of lesions. The CT-findings were compared with CVA symptoms (II). An aortic perfusion model was developed using cadaver aorta onto which multiple cross-clamp manipulations were applied (III). Washout samples of perfusate were analyzed by computerized image processing and with subdivision into different particle spectra. The model was further developed with the introduction of intraluminal manipulation from cannula and intra-aortic filter (IV). A technique for macro-anatomic mapping of plaque distribution of cadaver thoracic aorta was developed (V). Variation in plaque density was analyzed in different anatomical segments, monitored by digital image analysis. Hazards associated with surgical manipulation were studied by superimposing cannulation and cross-clamp sites onto the aortic maps in a blinded fashion. Results: The incidence of immediate and delayed CVA was 3.0% and 0.9%, respectively. Aortic quality was a strongly associated with immediate but not delayed CVA. Left-sided symptoms of immediate CVA were significantly more frequent than of the contra-lateral side. Positive signs on CT were seen in 66% of the CVA patients. Right-hemispheric lesions were more frequent compared with the contra-lateral side and the middle-cerebral artery territory dominated. Aortic cross-clamping produced a substantial output of particulate matter. Manipulation by intra-aortic filter produced a significant washout of embolic particles that escaped the filter, although some particles were captured. Cannulation was an additional source of embolic material. In terms of plaque distribution was the anterior wall of the ascending part and arch of the aorta more affected than its posterior side. However, observing a plaque in the anterior wall of this aortic segment predicted to 83% a concomitant plaque in the posterior wall. Increased age correlated positively with plaque density. The theoretical chance of interfering with a plaque during cannulation and/or clamp positioning was 45.8%. Conclusions: Both CT scans and clinical symptoms confirmed that CVA after cardiac surgery had a right-hemispheric predominance. The perfusion model resulted in a profound output of material during cross-clamp maneuvers. The intra-aortic filter successfully collected particles but also generated embolic debris on its own. Aortic cannulation was an additional source of embolic debris. Plaques were frequently found in the cadaveric aorta, and there was a high risk of plaque interference during surgical manipulation. As expected, plaque density was age-dependent.