The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses最新文献

筛选
英文 中文
A Cross-sectional Survey of Comprehension and Satisfaction of Spanish-Reading Adults Regarding RÁPIDO as a Stroke Awareness Acronym. 关于阅读西班牙语的成年人对 RÁPIDO 作为脑卒中认知缩写的理解和满意度的横断面调查。
Fiona S Smith, Hongyin Lai, Irene Tamí-Maury, Angelica Cornejo Gonzalez, Susan Stuart, M. Denny, Andrea Ancer Leal, A. Sharrief, V. Maroufy, S. Savitz, J. Beauchamp
{"title":"A Cross-sectional Survey of Comprehension and Satisfaction of Spanish-Reading Adults Regarding RÁPIDO as a Stroke Awareness Acronym.","authors":"Fiona S Smith, Hongyin Lai, Irene Tamí-Maury, Angelica Cornejo Gonzalez, Susan Stuart, M. Denny, Andrea Ancer Leal, A. Sharrief, V. Maroufy, S. Savitz, J. Beauchamp","doi":"10.1097/JNN.0000000000000755","DOIUrl":"https://doi.org/10.1097/JNN.0000000000000755","url":null,"abstract":"ABSTRACT\u0000BACKGROUND: Delay time to hospital arrival may be influenced by lack of recognition of stroke signs and the necessity to seek emergency medical, which in turn is influenced by language barriers to, a modifiable risk factor, stroke awareness education. The objective was to determine the comprehension and satisfaction of a Spanish stroke awareness acronym, RÁPIDO, among community-living, Hispanic and Latino, Spanish-reading adults. METHODS: A 33-item survey was completed by 166 adults. Data on sociodemographics, language preferences, stroke education, and comprehension and satisfaction with RÁPIDO were collected. Descriptive characteristics were calculated. Fisher exact tests were performed to determine whether reading language (group 1, only or predominantly reads in Spanish; group 2, reads in Spanish and English equally or reads predominately in English) influenced survey responses. Responses to open-ended questions were categorized. RESULTS: Sixty-nine percent of the participants were born outside of the United States, 82% currently resided in the United States, 34% read only or predominately in Spanish, and 7% had a stroke. Most participants thought RÁPIDO was informative, eye-catching, and easily remembered. Significant differences were found between reading language preference groups for correctly identifying RÁPIDO images for facial drooping (group 1, 80%; group 2, 95%; P ≤ .001) and dizziness/loss of balance (group 1, 54%; group 2, 73%; P = .027). Eighty percent or more of all participants were able to correctly interpret RÁPIDO images for facial drooping, blurry vision, impaired speech, and call emergency services. Adding \"911\" to the RÁPIDO image of the clock was a common suggestion. CONCLUSIONS: RÁPIDO was well received among the participants. Modifications to RÁPIDO images representing dizziness/loss of balance and arm weakness, and the addition of \"911\" may improve its usefulness. Obtaining more extensive feedback across the United States and testing the effect of RÁPIDO on increasing knowledge of stroke signs and retention of that knowledge are necessary next steps.","PeriodicalId":94240,"journal":{"name":"The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses","volume":"93 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140725144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Nursing and the Art of Making It Happen. 护理与实现的艺术。
DaiWai M Olson
{"title":"Nursing and the Art of Making It Happen.","authors":"DaiWai M Olson","doi":"10.1097/JNN.0000000000000756","DOIUrl":"https://doi.org/10.1097/JNN.0000000000000756","url":null,"abstract":"","PeriodicalId":94240,"journal":{"name":"The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses","volume":"59 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140722744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Effect of the Stopping Elderly Accidents, Deaths, and Injuries Program on Falls Prevention in Neurosurgical Patients. 制止老年人意外事故、死亡和伤害计划对预防神经外科患者跌倒的影响。
Hebah Alsaqer, Jehad A. Rababah, M. Al-Hammouri, Mohamed M Barbarawi, Mohammad Suliman
{"title":"The Effect of the Stopping Elderly Accidents, Deaths, and Injuries Program on Falls Prevention in Neurosurgical Patients.","authors":"Hebah Alsaqer, Jehad A. Rababah, M. Al-Hammouri, Mohamed M Barbarawi, Mohammad Suliman","doi":"10.1097/JNN.0000000000000753","DOIUrl":"https://doi.org/10.1097/JNN.0000000000000753","url":null,"abstract":"ABSTRACT\u0000BACKGROUND: Despite the negative consequences of falls among neurosurgery patients in acute care settings, there is a lack of high-quality evidence for successful fall prevention programs. This study was conducted to evaluate the effectiveness of the Stopping Elderly Accidents, Deaths, and Injuries (STEADI) program on falling prevention compared with routine falling protocol in neurosurgical patients in Jordan. METHODS: A prospective quasi-experimental design was used in this study. The sample comprised 70 neurosurgical patients from a major university-affiliated hospital in Jordan. The study sample was assigned into a control group (35 patients) and an intervention group (35 patients). A demographics questionnaire, and different fall risk screening tools and tests were used in this study as recommended by the STEADI program. RESULTS: Multivariate analysis of variance results showed a significant effect (P = .001) of the STEADI program on the linear combination of outcome measures. Independent samples t tests further confirmed the program's effectiveness, with statistically significant mean differences in most outcome measures between the intervention and control groups post intervention. After implementing the study intervention, participants in the intervention group had a statistically significant lower risk for falls. CONCLUSION: The findings indicate potential effectiveness in improving neurosurgery patients' outcomes and reducing the risk of falls. Implementing the study recommendations can enhance patient safety and promote evidence-based fall prevention interventions in neurosurgery patients.","PeriodicalId":94240,"journal":{"name":"The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses","volume":"33 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140721269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Essential Components of a Neuroscience Nursing Orientation: A Delphi Study. 神经科学护理方向的基本要素:德尔菲研究。
The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses Pub Date : 2024-04-01 Epub Date: 2024-02-03 DOI: 10.1097/JNN.0000000000000748
Cynthia Bautista, Marianne Beare Vyas, Lorin Daniels, Mary Guanci, Lori Rhudy
{"title":"Essential Components of a Neuroscience Nursing Orientation: A Delphi Study.","authors":"Cynthia Bautista, Marianne Beare Vyas, Lorin Daniels, Mary Guanci, Lori Rhudy","doi":"10.1097/JNN.0000000000000748","DOIUrl":"10.1097/JNN.0000000000000748","url":null,"abstract":"<p><strong>Abstract: </strong>BACKGROUND: The essential components of an effective neuroscience nurse orientation program for those caring for the adult general care population have not been well defined or standardized. METHODS : Using a 2-round, modified Delphi methodology, electronic surveys were distributed to 53 experts in neuroscience nursing orientation to gain consensus on the essential components of orientation for the neuroscience nurse. Survey data included demographics of the expert, literature-based components of neuroscience nurse orientation, and an opportunity to agree/disagree or write in additional components. RESULTS : Round 1 of the consensus survey elicited a response rate of 55% (29/53), and round 2 had a 51% (27/53) response rate. On the basis of round 1 expert responses, 4 new orientation components were added, and 36 components of a neuroscience nursing orientation were revised to include only the elements with ≥75% agreement. Twenty-two elements in round 2 met the criteria of ≥75% very important and important to include as components of a neuroscience nursing orientation. CONCLUSION : An expert consensus was reached on the necessary components of a neuroscience nursing orientation. The identified neuroscience nursing orientation components concentrated on improving nursing practice and provision of care to adult neuroscience patients. This study demonstrates priority components within a standardized orientation program for neuroscience nurses based on literature and expert consensus. A comprehensive neuroscience nursing orientation is a vital step in sustaining high-quality care for patients and improving neurological outcomes.</p>","PeriodicalId":94240,"journal":{"name":"The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses","volume":" ","pages":"49-53"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139984967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Letter to the Editor: Telestroke and Artificial Intelligence. 致编辑的信:远程中风与人工智能。
The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses Pub Date : 2024-04-01 Epub Date: 2023-12-26 DOI: 10.1097/JNN.0000000000000747
Jennifer L Wessol
{"title":"Letter to the Editor: Telestroke and Artificial Intelligence.","authors":"Jennifer L Wessol","doi":"10.1097/JNN.0000000000000747","DOIUrl":"10.1097/JNN.0000000000000747","url":null,"abstract":"","PeriodicalId":94240,"journal":{"name":"The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses","volume":" ","pages":"32"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139050034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Systematic Review and Critical Appraisal of Role Definition and Responsibility Within the Concussion Management Team for Secondary Schools. 对中学脑震荡管理团队的角色定位和责任进行系统回顾和批判性评估。
The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses Pub Date : 2024-04-01 Epub Date: 2024-01-09 DOI: 10.1097/JNN.0000000000000744
Joseph Fetta, Angela Starkweather, Robert Huggins, Thomas Van Hoof, Douglas Casa, Jessica Gill
{"title":"Systematic Review and Critical Appraisal of Role Definition and Responsibility Within the Concussion Management Team for Secondary Schools.","authors":"Joseph Fetta, Angela Starkweather, Robert Huggins, Thomas Van Hoof, Douglas Casa, Jessica Gill","doi":"10.1097/JNN.0000000000000744","DOIUrl":"10.1097/JNN.0000000000000744","url":null,"abstract":"<p><strong>Abstract: </strong>BACKGROUND: Sports- and recreation-related concussions impact the cognitive function of secondary school students during the recovery process. They can cause symptoms such as headache, difficulty concentrating, and memory impairment, which pose a challenge for students during the return to learn (RTL) after injury. Concussion management teams (CMTs) assist the student in managing symptoms and develop an individualized RTL process; however, the ideal composition of professionals involved in the CMT has not been fully evaluated. METHODS: A systematic review was conducted to assess current research on CMTs in secondary schools. A search of the databases CINAHL, MEDLINE, and PsycINFO was conducted using the search terms \"concussion management team\" AND \"school\" OR \"return to learn.\" RESULTS: Twenty-four articles were included for review. The CMT structure was highly variable in all studies. Identified themes from the literature were confusion of role definition and function, and communication gaps among interdisciplinary team members. Half of the articles viewed the school nurse as the leader in coordinating the CMT and RTL process. CONCLUSION: Evidence from this review suggests further consensus in this field is needed to clarify the school nurse's role and standardize the CMT structure.</p>","PeriodicalId":94240,"journal":{"name":"The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses","volume":" ","pages":"33-41"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139418888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Relationship Between Care Preparedness and Altruism Levels in Caregivers of Stroke Patients. 中风患者护理人员的护理准备与利他主义水平之间的关系。
The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses Pub Date : 2024-04-01 Epub Date: 2023-12-11 DOI: 10.1097/JNN.0000000000000745
Ayşe Çekici, Afife Yurttaş
{"title":"The Relationship Between Care Preparedness and Altruism Levels in Caregivers of Stroke Patients.","authors":"Ayşe Çekici, Afife Yurttaş","doi":"10.1097/JNN.0000000000000745","DOIUrl":"10.1097/JNN.0000000000000745","url":null,"abstract":"<p><strong>Abstract: </strong>BACKGROUND: Stroke care partners and caregivers experience emotional and physical burden, and 80% of stroke patients need support after discharge. This study examines the relationship between caregiver preparedness and altruism levels of stroke patients. METHODS: The population of this descriptive and correlational study consisted of the caregivers of stroke patients who were hospitalized at the stroke center of a hospital between January 2021 and August 2021. The sample was determined as 240 with the known sampling formula. The descriptive information form, the Preparedness for Caregiving Scale, and the Altruism Scale were used to collect the study data. RESULTS: The total mean score of the caregivers' preparedness to provide care was found to be 25.04 (7.36), and the mean total altruism score was 85.78 (9.20). The mean score of Donation, which is one of the subdimensions of the Altruism Scale, was 26.67 (4.08), and that of Helping Status was 59.10 (6.92). No statistically significant relationships were detected between caregivers' preparedness to provide care scores, Helping Status scores, Donation scores, and total altruism scores in this study ( P = .241, P = .245, and P = .129, respectively). CONCLUSION: No statistically significant relationships were detected between the preparedness and altruism levels of the caregivers of the stroke patients in this study.</p>","PeriodicalId":94240,"journal":{"name":"The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses","volume":" ","pages":"60-64"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138814717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Dissemination Beyond the Edge of the Page. 超越页面边缘的传播。
The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses Pub Date : 2024-04-01 Epub Date: 2024-02-08 DOI: 10.1097/JNN.0000000000000750
DaiWai M Olson
{"title":"Dissemination Beyond the Edge of the Page.","authors":"DaiWai M Olson","doi":"10.1097/JNN.0000000000000750","DOIUrl":"10.1097/JNN.0000000000000750","url":null,"abstract":"","PeriodicalId":94240,"journal":{"name":"The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses","volume":" ","pages":"31"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139984966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Consistently Exploring Nurse Staffing and Neurocritical Care Unit Turnover. 持续探索护士人员配备与神经重症监护病房人员流失问题。
The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses Pub Date : 2024-04-01 Epub Date: 2024-01-10 DOI: 10.1097/JNN.0000000000000742
Brittany R Doyle, Lisa M Smith, Jade L Marshall, Byron A Carlisle, Anjali C Perera
{"title":"Consistently Exploring Nurse Staffing and Neurocritical Care Unit Turnover.","authors":"Brittany R Doyle, Lisa M Smith, Jade L Marshall, Byron A Carlisle, Anjali C Perera","doi":"10.1097/JNN.0000000000000742","DOIUrl":"10.1097/JNN.0000000000000742","url":null,"abstract":"<p><strong>Abstract: </strong>BACKGROUND: Staffing models within nursing units have long been a hot topic of discussion. The COVID-19 pandemic exacerbated this discussion by straining the national nursing environment and workforce. Before the pandemic, the neuroscience intensive care unit (NSICU) primarily used an acuity-adjusted staffing model and aimed for a nurse-to-patient ratio of 1:1.5. During and after the pandemic, the NSICU was forced to primarily use a centralized staffing model because of the increased turnover in the hospital at large and a rise in patient census. METHODS : Unit census data in an NSICU were tracked before, during, and after the pandemic alongside utilization of a centralized staffing model in the hospital at large. RESULTS : During this time, the NSICU saw a statistically significant increase in average nurse-to-patient ratio and incidences of both floating and tripled assignments. The NSICU simultaneously saw a 180% increase in nursing turnover. CONCLUSION : Although we cannot prove that a centralized staffing model is directly responsible for higher nursing turnover, its utilization led to greater incidence of poor staffing-reflected in deviation from the nurse-to-patient ratio goal of the unit. Nurse staffing concerns play a large role in nurse satisfaction in the workforce: staffing shortages have been described both as a precursor to and as a consequence of increased nursing turnover.</p>","PeriodicalId":94240,"journal":{"name":"The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses","volume":" ","pages":"54-59"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139486906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Use of Family Photographs Reduces Restlessness in Neurocritical Care Patients. 使用家庭照片减少神经危重症患者的不安。
The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses Pub Date : 2024-02-01 Epub Date: 2023-11-06 DOI: 10.1097/JNN.0000000000000725
Cole Givens, Emerson B Nairon, Mona Jackson, Ayushi Vashisht, DaiWai M Olson
{"title":"Use of Family Photographs Reduces Restlessness in Neurocritical Care Patients.","authors":"Cole Givens, Emerson B Nairon, Mona Jackson, Ayushi Vashisht, DaiWai M Olson","doi":"10.1097/JNN.0000000000000725","DOIUrl":"10.1097/JNN.0000000000000725","url":null,"abstract":"<p><strong>Abstract: </strong>BACKGROUND: Patients admitted to the neuroscience intensive care unit often experience varying states of confusion and restlessness. The purpose of this study was to examine restlessness in acutely confused patients through use of familiar photographs. METHODS : This randomized prospective pilot study placed family photographs (photos) on the bedrail of confused patients during the night shift (8 pm to 4 am ) in a neuroscience intensive care unit. Wrist actigraphy was used to examine restlessness when patients were turned to face the photos versus when they were not facing the photos. RESULTS: The 20 patients enrolled provided 34 nights worth of data during which 32 640 actigraph readings were obtained. On the first night of study, the odds of wrist movement were higher when the patient was facing the photos compared with not (odds ratio, 1.51; 95% confidence interval, 1.42-1.61). During subsequent nights, the odds of wrist movement were lower when the patient was facing the photos compared with not (odds ratio, 0.82; 95% confidence interval, 0.75-0.90). CONCLUSION : Use of familiar photos does not change restlessness, agitation, or delirium on the first night of observation. However, the use of familiar photos may decrease restlessness on the subsequent nights. There are important subjective observations from researchers and family that suggest all subjects had a noticeable response when initially seeing the familiar photos.</p>","PeriodicalId":94240,"journal":{"name":"The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses","volume":" ","pages":"6-11"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136400920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
相关产品
×
本文献相关产品
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信