Iran Journal of Nursing

Introduction
One of the problems that threaten children in developing countries is the issue of child labor. Due to the special conditions in their lives, these children are deprived of childhood and their different family and social aspects are affected. Thus, they are among the most vulnerable populations. According to the International Labor Organization, the general minimum age for light work is 13. Light works are those not engaged in military or drug-related activities and do not interfere with the child’s education, physical and mental development. One of the disadvantages of child labor is its effects on children’s mental health. 
One of the mental health aspect that is damaged by child labor is hope. Maltreatment, abuse, violence, and neglect of these child causes the feeling of despair in them. In some studies, it was reported that 52% of child laborers who were completely separated from their families experienced a feeling of hopelessness, and had lower hope for the future than their normal peers. In addition, child labor can have a negative effect on the growth and cognitive performance of children. Cognitive structures that organize thoughts are called schemas. Maladaptive schemas include dysfunctional thoughts, beliefs, and attitudes towards self and others. These schemas are more common in children with low quality of life and social support who face more loneliness and interpersonal problems. Due to the negative effects and consequences of child labor, there is a need for systematic studies for the identification of mental health dimensions, such as hopelessness and dysfunctional attitude in child laborers. This study aims to determine the prevalence of hopelessness and dysfunctional attitude in child laborers of Tehran.

Materials and Methods
This is a descriptive cross-sectional study. The study population consists of all children and adolescents engaged in child labor aged 10-18 years covered by the child laborers support centers in the south of Tehran including Molavi (n=134), Bazar (n=134), Khavaran (n=144), and the center for all children (n=8). In During visit to each center, the study objectives were explained to children. The parents of children aged 10-15 signed the consent form at home (due to the pandemic). Children aged 15-18 signed the consent form themselves. The inclusion criteria for were being literate, at least one year of working in child labor centers, and not experiencing a tragic event such as the death of parents or loved ones in the past six months. Finally, 247 eligible children were selected (92 from Molvi, 70 from Bazar, 80 from Khavaran, 5 from the center for all children) using a continuous sampling method, lasted for 8 months from April to November 2021. The data collection tool were a demographic form and the children’s dysfunctional attitude scale (DAS) of D’Alessandro and Burton, and the hopelessness scale for children (CHS) of Kazdin et al. (1986) [33]. The collected data were analyzed using descriptive statistics (mean, standard deviation, frequency and percentage) and inferential statistics (analysis of variance, independent t test and Pearson’s correlation test) in SPSS software, version 16. The significance level was set at 0.05.

Results
Most of participants were at the age group of 10-12 years (42.90%), 53.44% were boys and the rest were girls. The children were studying in the first to sixth grades, mostly in the 3-4th grade (31.20%). Moreover, 43.31% were student only, while 56.70% were both student and laborer. The guardian of most children was parents (80.56%); 66.80% of children were non-Iranian and the rest were Iranian. Most of children had a household size of 7-8 persons (36%). Most of laborer children were peddling (32.90%) and sewing (24.30%). The duration of support from the centers for the most of children was ≤3 years (64.01%).
The results showed that the hopelessness (Mean= 7.63±1.96) of children under the support of centers was at a moderate level. Among the domains of CHS, future expectations (38.70±18.67) had higher score than the feelings about the future domain (28.51±19.81). Also, the  dysfunctional attitude (Mean= 74.16±16.96) of children was at a moderate level. The dysfunctional attitude had a statistically significant relationship with education (P=0.026), guardianship status (P=0.029) and duration of support from the supporting centers (P=0.022). There was no significant correlation between dysfunctional attitude and hopelessness (p>0.05). Hopelessness only had a significant relationship only with the work status of children (p=0.029), although Tukey’s post hoc test did not show a statistically significant difference.

Conclusion
Based on the results of the present study, the levels of hopelessness and dysfunctional attitude in child laborers in the south of Tehran were moderate, and there was no significant relationship between their dysfunctional attitude and hopelessness. It is recommended to conduct more studies on child laborers with a longer duration. Interventional studies should be conducted for improving the future expectations of children and assess the effect of cultural, economic, and social factors on hopelessness and dysfunctional attitude of child laborers. The highest dysfunctional attitude was seen among children under the guardianship of others and with a 2-year support from the supporting centers. Therefore, it is recommended to focus more on these children laborers for intervention to improve their dysfunctional attitude. Considering the lack of significant relationship between dysfunctional attitude and hopelessness in children laborers, it is recommended that the mediating and confounding variables be investigated.

Ethical Considerations
Compliance with ethical guidelines
 Ethical approval for this study was obtained from the Ethics Committee of Iran University of Medical Sciences (Code: IR.IUMS.REC.1399.1162)

Funding
This study was extracted from the master thesis of Mehrnoosh Inanloo, approved by the Department of Psychiatry, School of Nursing and Midwifery, Iran University of Medical Sciences.

Authors' contributions
Conceptualization: Mehrnoosh Inanlou, Naime Seyed Fatemi, Fereshte Ghasemi; investigation: Mehrnoosh Inanlou and Fereshte Ghasemi; data analysis: Shima Haqqani; project administration: Mehrnoosh Inanlou and Naime Seyed Fatemi; Editing and review: Farishte Ghasemi.

Conflict of interest
The authors declare no conflict of interest.

Acknowledgments
The authors would like to thank all the children participated in the research and Mr. Qasem Hasani, manager of the child laborers support centers in Tehran for their cooperation. 


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