The Concept of Double Protection in the Childhood Cancer Context.

BACKGROUND: The concept of double protection is used to describe communication avoidance used by parents and their child or adolescents with cancer in attempts to protect the other against disease-related stress and emotions, resulting from communication about the cancer, its treatment, and thoughts. This concept has received limited attention in the research literature. OBJECTIVES: The aims of this concept analysis are to (1) explore its defining characteristics, applicability, and utility, (2) spotlight the concept and increase awareness and interest among healthcare providers and researchers, and (3) provide a direction for future interventions to improve parent-child communication in the childhood cancer context. METHODS: Rodgers' Evolutionary Concept Analysis was used, and the findings from a study that explored the communication experience of Korean adolescents with cancer and their parents were integrated. RESULTS: This study explored the attributes, antecedents, consequences, and related terms. The following attributes were extracted: intention to protect, bidirectional, and absence of parent-child communication at a deeper level. CONCLUSION: Clarification of the concept of double protection provides insight into the concept as a barrier to engagement in parent-child communication and supports the significance of double protection in the childhood cancer context. IMPLICATIONS FOR PRACTICE: There is a need for increased awareness of the challenges and dangers inherent in family communication avoidance, double protection. In order to address the issue, developing developmentally appropriate and valid clinical assessment tool and interventions are required. More research on the evidence-based benefits of effective parent-child communication is also required.