Design This is a cross-sectional study involving quantitative measures and qualitative interviews. Participants Sixteen brain injured men and four brain injured women participated. Eighteen of these had a close relative who also took part. Measures In addition to being interviewed, brain injured participants completed questionnaires on mood symptoms and fatigue, and a speed of information processing task. Relatives of brain injured people were interviewed and completed the symptom checklist. Correlational analysis was applied to the quantitative measures and- qualitative analysis was informed by the grounded theory approach. Results Quantitative measures suggest significant association of subjective perception of fatigue severity with mood and brain injury related symptoms. Relatives' objective perceptions of brain injured relatives' symptoms correlated significantly with subjective views. Subjective perception of fatigue did not correlate significantly with severity of brain injury or information processing speed. Qualitative analysis identified fatigue as a major problem for some people. Descriptions noting the impact of fatigue following injury included increased slowness, decreased energy, and lack of control. Fatigue was commonly considered to be more mental than physical, and was often linked with short temper. Conclusions Findings suggest that fatigue was related less to severity of injury than to psychological and emotional factors. The multidimensional nature of fatigue was confirmed. Links were made with low-mood, anxiety, lack of motivation, boredom, and having to cope with 'normal life' following brain injury. The possibility that 'fatigue' is an umbrella term used by some to describe a range of symptoms following brain injury was considered.

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