All the variables presented in the study were positively correlated with the students' clinical clerkship satisfaction; while, neurosis was negatively correlated. Findings are in concert with previous studies declaring similar associations in this regard. According to previous studies and the logical exception, all the correlations with students' clinical clerkship satisfaction were sensibly assumed, except positive correlation of emotion-focus coping considering the previous literature, it was presumed to be negative [28, 8]. Temporary use of emotion-focused coping in situations, which are not controllable, like experiencing a heart attack or waiting to undergo a surgery, can be beneficial but the case is different with long-run use of it as a special coping style [29]. As a result, a negative correlation between using emotion-focused coping style in students and satisfaction with their clinical clerkship cannot be took granted and the obtained results might be due to the situations in which the participants in the present study faced them.
The results of regression analysis showed that spirituality predicts satisfaction with clinical clerkship among intern nursing students. In other words, considering the definition of spirituality, the students who found it meaningful and sacred, they, in their clinical practice, were more satisfied with their clinical clerkship. These findings are consistent with previous studies [30, 12, 31]. In religious society of Iran, religion and spirituality are intertwined and individuals believe in God as an omnipotent helping individuals to surmount their hardships. In a study conducting in Iran, it was concluded that Iranian nurses consider helping patients as an act of worshiping and believe that this contribution brings them spiritual rewards [16]. Evaluation of job values and job satisfaction among neophyte nurses [7], revealed that "philanthropic" values play an important role in nurses' job satisfaction and nurses who look at their job as an opportunity to help other people enjoy more satisfaction with their job. It seems that among Iranian students of nursing, some spiritual values are assimilated into job values and cause an increase in their satisfaction with clinical practice [31]. Also, it was found that problem-focused coping can predict satisfaction with clinical clerkship and emotion-focused coping has no role to play here, which is consistent with available evidence [32, 28].To put it another way, the students who try to encounter reality shock and the factors producing stress in clinical settings and find a way around are more satisfied with their clinical practice comparing with those are motivated by excitation of stressful events that they face.
Among five factors of personality, only extraversion predicted satisfaction with clinical clerkships among intern nursing students. Considering the definition of extraversion [11], students who were sociable, lovers of others and enjoyed talking to patients and also, those who had a tendency to acquire various experiences from their clinical practice, were more satisfied with their clinical clerkship [33, 34]. It was also found that spirituality predicted problem-focused coping which could be translated to the fact that students who could find sacredness in their clinical practice resort to problem-focused coping when they are situated in distressing clinical practice [35]. Although a few studies have been carried out on the relationship between spirituality and general coping strategies, most of these studies refer to the role of spirituality as a way to cope with stress as "spiritual coping" [36, 37]. In a conducted probe, three roles to spirituality/religion in coping process were assigned: 1) proposing a meaning for life, 2) feeling of control in various situations, and 3) building self-esteem in individuals [38]. Justifying the role of spirituality in predicting problem-focused coping among intern nursing students, spirituality contributes in dealing and finding a solution in a way that students will be able of facing their distressing clinical settings with a problem-focused coping style. The results of regression analysis showed that extraversion and openness could predict problem-focused coping. Extraversion, as a general tendency to be assertive, is defined as being active and doing gregarious practice. These individuals tend to be cheerful and therefore, it is logical to assume turning to others [39] and seeking social support as a subpart of problem-focused coping style [29]. Openness (to clerkship experiences), also, is defined as the tendency to ponder novel ideas, unconventional values, and divergent thinking. Therefore, it can be assumed that those who score high in openness are flexible, creative, and capable of exploiting a number of coping strategies more efficient to deal with distressing situations [39].
In sum, among the variables of personality dimension, only extraversion could predict emotion-focused coping. As a whole, these variables are not capable predictors of emotion-focused coping. These findings may be due to the fact that nursing students who face the reality shock, and stress from clinical practice can only do surmount their problems in future by sealing them, not committing self-blame and self-recrimination [40]. Also, the results of earlier studies showed that students employ problem-focused strategies at the period rather than emotion-focused strategies [32].
Conclusion and Recommendation
Based on the findings, it can be concluded that spirituality is an important factor in predicting nursing students' satisfaction with their clinical clerkships. Using problem-based coping in students and paying attention to their spiritual needs can be effective both in coping with the stressful situations of clinical work and in enhancing their satisfaction with clinical clerkships. Also, helping students to resolve their clinical problems rationally and enhancing their problem solving skills in dealing with clinical stress can be associated with their satisfaction with clinical experience. Considering the role of extraversion and the problem-focused coping in predicting the satisfaction of clinical experiences in nursing students, it can be concluded that Probably, the training of social behaviors, communication skills and proper interaction with patients and hospital staff (extraversion characteristics) can also help nurses in effective coping with stressful work situations and also increase their satisfaction with their clinical experiences.
Limitations
Considering the difficulties encountered by nursing students when they enter the clinical practice, there is a need for further study on this issue. In order to be more confident in the findings of this study, especially with regard to limited studies on the role of spirituality in clinical work and the spiritual needs of nursing students, more similar studies are suggested. Given that spirituality [41] and coping strategies [42] are to some extent dependent on ethnicity, the generalizations of the research findings to other ethnic groups should be carried out with caution and it is suggested that similar studies be conducted in other ethnic groups. This cross-sectional study was conducted to assess the factors predicting clinical clerkship satisfaction, it is suggested that further studies utilized longitudinal method to assess these factors.