Positive spirituality in secular healthcare contexts. A Francophone conceptual framework for global health and migrant spiritual care

Abstract Literature on spiritual care is largely produced in English within Anglo-Saxon institutional contexts, which limits its applicability in other cultural settings. This article presents two empirically grounded conceptual models developed in French-speaking healthcare contexts and examines their relevance for spiritual care in global health and migration contexts. The first model is based on narratives from 22 spiritual care providers in Quebec. Their understandings of spirituality aligned with six core dimensions (meaning, transcendence, values, identity, belonging, and rituals), providing empirical support for a practice-based assessment framework widely used in Quebec healthcare. The second model results from a multi-round expert consensus process conducted across five French-speaking countries. It offers a shared conceptualisation of positive spirituality structured around three central attributes: connectedness, meaning of life, and identity. A central argument of the article is that the non-confessional design of both models, developed within secular institutional environments, makes them well-suited to culturally diverse populations. Unlike faith-based tools, they allow for spiritually sensitive care without presupposing religious affiliation, though the article acknowledges that both models bear the conceptual marks of their Western institutional origins. Together, these models complement existing approaches by emphasising strengths rather than distress, and by privileging transnational elaboration over single-context frameworks. These are illustrated through clinical examples and practical principles for spiritual care in global health and migration contexts.