<![CDATA[Background: Spiritual care is internationally recognised as a core dimension of palliative nursing, yet its integration into routine clinical practice remains inconsistent, particularly in Muslim-majority and non-Western settings where culturally responsive frameworks are lacking. Purpose: To systematically map evidence on spiritual care integration in palliative nursing, focusing on multi-level barriers, intervention characteristics across cultural contexts, and implications for Islamic healthcare settings. Method: A scoping review was conducted using the Arksey and O'Malley framework, the JBI methodology, and the PRISMA-ScR guidelines. Four databases, PubMed, Scopus, DOAJ, and Europe PMC, were searched in May 2026 for studies published between January 2015 and May 2026 in English or Indonesian. Results: Thirty‑seven studies were included. Barriers to integrating spiritual care emerged at individual, organizational, and system levels, with inadequate documentation, unclear role definitions, and limited institutional support as the most persistent challenges. While universal principles of spiritual care were consistently reflected, effective interventions varied across religious, cultural, and healthcare contexts. The synthesis highlights contextual adaptation as essential for translating universal principles into meaningful practice, particularly within Muslim‑majority healthcare settings. Conclusions: Integrating spiritual care into palliative nursing requires not only individual competence but also organizational readiness, interdisciplinary collaboration, and sensitivity to patients’ religious and cultural contexts. This review introduces a conceptual framework that situates contextual adaptation as the link between universal principles of spiritual care and their clinical application, thereby supporting culturally responsive practice and guiding future model development.]]>
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