<![CDATA[Cardiovascular disease (CVD) remains a leading cause of global morbidity and mortality. Beyond physical symptoms, patients frequently experience psychological distress, existential concerns, and spiritual needs that may influence coping, treatment adherence, and overall well-being. Although spiritual care is increasingly recognized as a component of holistic cardiovascular nursing, evidence regarding nurse-led spiritual care remains heterogeneous in terms of intervention models, implementation strategies, cultural adaptation, and reported outcomes. This scoping review aimed to systematically map nursing approaches to spiritual care for adults with CVD and summarize their implementation across clinical settings. The review followed the PRISMA Extension for Scoping Reviews (PRISMA-ScR) guidelines. Searches were conducted in PubMed, Scopus, Web of Science, CINAHL, and ScienceDirect for studies published between 2015 and 2025. Quantitative, qualitative, and mixed-methods studies involving nurse-led or nurse-integrated spiritual care interventions were included. Eighteen studies met the eligibility criteria. Thematic synthesis identified four categories of nursing approaches: spiritually supportive communication, faith-based spiritual interventions, mindfulness- and meaning-centered approaches, and holistic spiritually integrated nursing care. These interventions were implemented across acute care, coronary care, cardiac rehabilitation, outpatient, palliative, and community settings. Reported outcomes encompassed psychosocial, spiritual, patient-centered, and selected physiological domains, with anxiety reduction, emotional comfort, coping, spiritual well-being, quality of life, and patient satisfaction being the most frequently described outcomes. This review provides a comprehensive overview of contemporary nursing approaches to spiritual care in cardiovascular practice, highlights important variations in intervention characteristics and outcome assessment, and identifies priorities for developing standardized, culturally responsive, and theory-informed spiritual care frameworks and future cardiovascular nursing research.]]>
