Abstract
BACKGROUND: Spiritual care is an essential component of palliative care, supporting the existential and spiritual wellbeing of patients with serious illnesses. Yet, its effective implementation remains challenging in many healthcare systems. This study examines the experiences and practices of palliative care clinicians in Lebanon, a country characterized by religious diversity, high religiosity, and a complex political landscape. METHODS: A qualitative focus group study rooted in constructionist ontology. Palliative care clinicians were recruited from community and acute settings in Lebanon. Data were analyzed using reflexive thematic analysis. RESULTS: Three overarching themes: (1) the political context and religious tensions create sensitivities around spiritual care provision, (2) existing spiritual assessment tools are incompatible with local needs, and (3) the desire to safeguard therapeutic connection drives adaptations in spiritual care provision. Participants highlighted how religious and political tensions in Lebanon complicate spiritual care delivery, with concerns about judgment, religious discordance, and cultural misalignment. Western-developed approaches were deemed culturally incongruent, prompting providers to adapt or abandon standardized approaches in favor of personalized, context-sensitive methods. Adaptations included fostering environments for spontaneous spiritual discussions and tailoring assessments to individual patient needs. CONCLUSIONS: This study contributes to the growing discourse on the importance of contextualizing palliative care to meet the unique needs of diverse populations, particularly in settings marked by religious and political complexity. Future research should focus on developing context-specific approaches. Training programs should support providers in delivering effective, culturally sensitive spiritual care.