Psychosocial Burden of Infertility, Psychoeducation and Distress Screening among Adults in Couple Relationships in Juba, South Sudan: A Convergent Mixed-Methods Study

Infertility has psychological, relational, sociocultural and economic consequences that may remain insufficiently addressed when care concentrates primarily on biomedical diagnosis and treatment. This study examined the psychosocial influence of infertility among adults in Juba, South Sudan; assessed the importance of psychoeducation within psychosocial management; and evaluated the usefulness of psychosocial assessment domains for identifying stress and depression-related distress. A pragmatist, convergent mixed-methods analytical cross-sectional design was used. The completed database contained 100 individual participant records within an intended 50-couple study framework. Quantitative data were analysed using descriptive statistics, group comparisons, correlation, regression, reliability and exploratory structure procedures, while qualitative responses were interpreted thematically. The overall psychosocial-influence score was high (M = 3.44, SD = 0.43). Family and community stigma recorded the highest domain mean (M = 3.95), followed by treatment-related emotional distress (M = 3.89) and economic burden (M = 3.54). Age groups differed significantly, F(3, 96) = 4.102, p = 0.009, although chronological age was not linearly associated with the composite score; treatment duration showed a significant positive correlation (r = 0.219, p = 0.028). Psychoeducation was rated highly (composite M = 3.94, SD = 0.43) and was moderately associated with adaptive coping (r = 0.460, p < 0.001); in the multivariable coping model it remained the significant predictor (β = 0.445, p < 0.001). The assessment domains captured clinically relevant emotional, relational and contextual information, but the four-domain internal consistency was modest (Cronbach's α = 0.463) and factorability was marginal (KMO = 0.589), indicating that the instrument should not be treated as a single validated psychometric scale. The study concludes that infertility in Juba is a biopsychosocial and relational experience requiring routine psychoeducation, couple-sensitive counselling, repeated distress screening, culturally responsive family and community engagement, and clear referral pathways. Further independent validation of distinct assessment subscales is recommended.