Objectives: The purpose of this study was to clarify factors influencing care workers\u27 attitudes toward end-of-life (EOL) care characteristics at special nursing homes (SNHs). Methods: A questionnaire was initially sent to 630 care workers at 19 SNHs in October 2012. Written informed consent was obtained from 253 of these workers (40.2%), who then completed and returned the questionnaires. Participants were asked to reply to questions covering demographic data, work environment, depression status, experiences/education concerning EOL, communication skills, and attitudes toward EOL care. The Japanese version of the Frommelt Attitude Toward Care of the Dying Scale, Form B (FATCOD-B-J) assessment instrument was used in the analysis of the data received. Using the median value of the FATCOD-B-J score, 130 subjects were allocated to the high score (HS) group (FATCOD-B-J?23) and 123 to the low score (LS) group (FATCOD-B-J<23). In the LS group, the odds ratios (ORs) and their 95% confidence intervals (95% CIs) of participants exhibiting relatively negative attitudes toward EOL care were calculated and adjusted for potential confounding factors using multivariate logistic regression model analysis. Results: Length of employment in the facilities of between 5 and 9 years (OR 0.37, 95% CI 0.16-0.87) as well as over 10 years (OR 0.39, 95% CI 0.16-0.96) was significantly associated with a decreased risk of placement in the LS group. Furthermore, moderate (OR 0.44, 95% CI 0.24-0.80) as well as high (OR 0.35, 95%CI 0.17-0.75) communication skills in accepting other opinions, were significantly associated with decreased risk of placement in the LS group. Conclusions: After adjustments for potential confounding variables, results indicated that extended experience as a care worker and higher communication skills in accepting other opinions were significantly associated with a reduced risk of negative attitudes toward EOL care
