ObjectiveThis study aimed to investigate the perceptions of elderly caregivers in Chinese nursing homes (NHs) and associated factors with regard to knowledge, attitude about elderly and self-efficacy.SettingA cross-sectional questionnaire survey was conducted in 12 NHs in Liaoning Province, China.ParticipantsA total of 403 caregivers from 12 NHs were surveyed.Outcome measuresData were collected using a self-administered questionnaire composed of the Palmore’s Facts on Aging Quiz I, Kogan’s Attitude Towards Old People Scale, General Self-Efficacy Scale and background characteristics of participants. An average score for knowledge, attitude and self-efficacy was calculated. Differences across groups were evaluated using Student’s t-test and analysis of variance. Multivariable linear regression models were established to estimate the associated factors.ResultsThe participating caregivers reported a relative low score on knowledge about the elderly (10.42±2.79), attitude towards old people (127.85±14.36) and self-efficacy (27.12±4.9). Multivariable regression analysis showed that respondents who had high educational level (β=0.212, 95% CI 0.193 to 0.824), received prejob training (β=0.193, 95% CI 0.081 to 1.169) and had high job satisfaction (general satisfaction: β=0.345, 95% CI 0.223 to 1.875; very satisfied: β=0.322, 95% CI 0.210 to 1.283) gave a positive rating on knowledge. Caregivers who were employed as formal staff (β=0.155, 95% CI 0.116 to 1.670), earned a high income (β=0.214, 95% CI 0.117 to 1.461) and had an interest in working with the elderly (β=0.141, 95% CI 0.088 to 1.508) tended to develop a positive attitude towards the elderly. However, caregivers who were female (β=−0.110, 95% CI −1.751 to −0.080) and had long work experience (β=−0.130, 95% CI −1.527 to −0.110) developed negative perception. Caregivers who were older (β=0.215, 95% CI 0.139 to 1.027), received prejob training (β=0.143, 95% CI 0.113 to 1.024), had an interest in working with the elderly (β=0.154, 95% CI 0.114 to 1.015), had high job satisfaction (β=0.177, 95% CI 0.116 to 1.223) and perceived better health status for the elderly (partial disability: β=0.437, 95% CI 0.259 to 1.600; no disability: β=0.288, 95% CI 0.153 to 1.211) gave a positive rating on self-efficacy.ConclusionKnowledge about the elderly, attitude towards old people and self-efficacy of elderly caregivers in Chinese NHs were at low levels. Some targeted intervention programmes, such as conducting professional training for aged care and a performance-based payment system, should be given priority to improve these attributes.