Introduction

According to a report by the Badan Pusat Statistik (BPS) in 2024, the growth in the number of elderly people in Indonesia continues to increase in line with the increase in life expectancy. The percentage of elderly people in Indonesia reached 12% in 2024, an increase of almost 4% compared to 2015. Life expectancy also showed an increase, from 70,78 years in 2015 to 72,39 years in 2024, which means that every person born in 2024 is expected to live to the age of 72. Meanwhile, East Java ranks second highest after DI Yogyakarta, with an elderly population percentage of 16,02%, indicating that the province of East Java is entering a phase of an aging population structure. This condition emphasizes the need for special attention to the risk of falls among the elderly in East Java, given the high elderly population and the significant impact of falls on the independence and quality of life of the elderly 1.

As they age, older adults experience various changes that can occur in internal factors, such as genetics, hormones, metabolism, the immune system, cell systems, and organ systems. In addition to being influenced by internal factors, changes in older adults are also influenced by various external factors, such as social changes, psychological changes, lifestyle, and stressors 2. This condition poses various challenges, one of which is an increased risk of health disorders and limited mobility in the elderly.

One of the main injuries experienced by many elderly people is falling. Falls among the elderly have the potential to reduce their independence in carrying out daily activities. This can also trigger a decline in self-confidence and make the elderly more cautious in their movements, thereby affecting their overall quality of life. Various efforts have been made to reduce the risk of falls among the elderly, one of which is the use of mobility aids, such as canes, wheelchairs, and rollator walkers. Wheelchairs do offer high stability, but their use tends to limit the independence of the elderly. Previous studies have shown that prolonged use of wheelchairs can cause immobilization, which can lead to pressure ulcers, joint pain, and muscle atrophy 3. In contrast, rollator walkers better support the independence of older adults in mobility. Other previous studies have shown that the use of rollator walkers has been proven to improve postural stability in older adults with muscle weakness or balance disorders 4. Compared to canes, rollator walkers are superior because they provide additional stability through wheels and a braking system.

On the other hand, academic studies on the development of rollator walkers in Indonesia are still limited, with research on mobility aids focusing more on wheelchairs, while studies on rollator walkers are almost non-existent, especially those exploring the emotional preferences of users. There has not been much research that seeks to develop rollator walkers that remain practical to use while also providing a sense of security for their users. From the aspect of a product that is compact and practical but still safe, there is still a gap in research to create a rollator walker product design that is able to minimize the risk of falling without reducing user practicality through the exploration of emotional preferences.

Previous research on mobility aids for the elderly using the Kansei Engineering approach has identified several Kansei Words used to explore users' emotional preferences. In the previous study, 11 relevant Kansei Words were used to explore the emotional preferences of wheelchair users, namely Dignity, Trustworthiness, Independence, Affirmation, Stylish, Stability, Safety, Comfort, Agility, Communicative, dan Futuristic5. Other previous studies have 9 Kansei Words were used, namely Technological, Comfortable, Safe, Sturdy, Concise, Round, Modern, Affordable, dan Lightweight to explore the emotional preferences of wheelchair users 6. When related to the development of rollator walkers as mobility aids for the elderly, the Kansei Words to be used in this study can be derived from previous studies. Therefore, 13 Kansei Words were obtained that can be used, including Sturdy, Lightweight, Stability, Agility, Trustworthiness, Safe, Comfortable, Dignity, Independence, Concise, Modern, Stylish, dan Affirmation.

In the context of product development, Kansei Engineering is a relevant product design approach that balances product functionality with the emotional experience of its users. This method is capable of translating users' emotional needs and preferences into product design attributes 7. In addition, this method has been proven effective in translating users' emotional needs into product design, as evidenced by previous study, which shows that Kansei Engineering is capable of producing functional products that also meet emotional needs. This study uses the Kansei Engineering Type I: Category Classification approach, which links users' subjective preferences for products with design characteristics that can be measured objectively 8. This approach enables the development of a rollator walker that not only fulfills functional aspects but also addresses the emotional needs of the elderly.

Based on this description, this research is important to develop rollator walker products for the elderly using the Kansei Engineering approach, resulting in designs that meet the functional and emotional needs of users. This research focuses on the elderly at the Hargo Dedali Nursing Home, a branch of Surabaya Nursing Home, to explore the emotional preferences of the elderly, which are used as a reference for the development of rollator walker products. At the Hargo Dedali Nursing Home, all elderly residents aged 58–88 years old experience a decline in mobility. They can be classified into pre-elderly (58–64 years old), young elderly (65–80 years old), and advanced elderly (81–88 years old). Table 1. shows that most of the elderly at the Hargo Dedali Nursing Home had experienced falls, totaling 12 people (54,5%). Meanwhile, 10 people (45,5%) had never experienced a fall. This condition is exacerbated by diseases such as gout, diabetes mellitus, cholesterol, hypertension, and osteoarthritis, which limit the ability of the elderly to move. As a result, many elderly people need mobility aids to support their daily activities. Even though there are elderly people who do not have the diseases mentioned above, their mobility still declines with age, as shown in their unstable gait. The gait of elderly people is influenced by several parameters, such as stride width, stride length, and walking speed. These three parameters generally decline by 10-20% in elderly people as they age, which can increase the risk of falling 9.

Me thod

This study is a qualitative study because it focuses on exploring the emotional preferences of the elderly toward rollator walker products. A qualitative approach was chosen because emotional needs cannot be fully measured numerically, but rather need to be understood by exploring the emotional preferences of older adults, which are used as a reference for developing rollator walker products. Although statistical analysis (validity test, reliability test, factor analysis, conjoint analysis) was used in the process to process the questionnaire data, the final result was still an understanding of the emotional preferences of the elderly.

In this study, there are two main variables that are important factors and are directly related to the issues being studied.

1. Dependent Variable

Dependent variables are variables that are affected by independent variables. In this study, the dependent variables include the rollator walker product design concept, which is the final result of product development.

2. Independent Variable

Independent variables are variables that affect dependent variables. In this study, the independent variables include Kansei Words, which can affect the final result of the rollator walker product development focused on the elderly.

1. Research Approach
2. Variable Identification and Definition
3. Data Collection Sources

The research data collected will be used to support the data processing process through the application of Kansei Engineering.

1. Primary Data

Primary data is information obtained firsthand, collected directly from the source. In this study, primary data was obtained through interviews with the management of the Hargo Dedali Nursing Home to obtain profiles of the elderly, including gender, age, disease history, and fall history. Other primary data was obtained through the distribution of questionnaires to the elderly.

2. Secondary Data

Secondary data is information obtained indirectly through an intermediary. Secondary data in this study was obtained from reports by the Badan Pusat Statistik (BPS) supporting data on the percentage and life expectancy of elderly people in 2015–2024; Kansei Words from literature studies; rollator walker product samples; and literature related to Kansei Engineering as a theoretical basis.

Result and Discussion

The first stage of product development is product planning, which determines the domain or scope of research 10. The domain or scope determined in this study is rollator walkers.

1. Product Planning
2. Concept Development

The second stage of product development is concept development, where target market needs are identified, alternative product concepts are created and analyzed, and one or more concepts are selected for further development and testing 10.

C. Data Collection

The data collected in this study was obtained from primary and secondary data sources. A profile diagram of the elderly consisting of gender, age, medical history, and history of falls, as shown in Figure 1.

Figure . Percentage Diagram of the Elderly Profile of the Hargo Dedali Nursing Home

Each disease history experienced by the elderly at the Hargo Dedali Nursing Home has an effect on mobility, as shown in Table 2.

Table . Impact of Disease History on Elderly Mobility

Before collecting product samples to be assessed by respondents based on 13 Kansei Words, the elements and sub-elements of the rollator walker product were identified with reference to existing products. Based on these elements and sub-elements, several combinations were made using the orthogonal array method in conjoint analysis, as shown in Table 13. The results of these combinations were then visualized into 12 product samples to be assessed by respondents based on 13 Kansei Words. The results of the first questionnaire, which consisted of the assessment of 12 product samples based on the 13 Kansei Words, underwent validity testing, reliability testing, factor analysis, and conjoint analysis.

D. Validity Test

Validity testing is used to determine the accuracy and precision of an instrument in performing its measurement function 18. The number of respondents in this study was 22 with a significance level (α) of 5%, resulting in an r_table using a r product moment table references of 0,423. The results of the validity test in Table 3. indicate that all items have an r_count> r_table, so the questionnaire results can be considered valid.

Table .Validity Test Results

E. Reliability Test

Reliability testing is used to determine the extent to which an instrument can be trusted19. The results of the reliability test in Table 4. indicate that the Cronbach's Alpha value obtained was 0,829 with N of items equal to 13. Therefore, the questionnaire results can be said to be reliable because the Cronbach's Alpha value obtained was greater than 0,6.

Table . Reliability Test Results

F. System-Level Design

The third stage of product development is system-level design, which involves defining the product architecture and dividing the product into subsystems and components 10.

1. Fa c tor Analysis

Factor analysis is a stage in research that aims to convert the correlations between Kansei Words related to product design into more meaningful factors 20.

a. Barlett ’s Test

Bartlett's test is used to determine whether Kansei Words related to product design are sufficiently correlated to be analyzed using factor analysis 20. The results of the Barlett’s test in Table 5. indicate that the significance value is less than 0,05; so Kansei Words are sufficiently correlated to be analyzed in factor analysis by grouping them into more meaningful factors.

Table . Barlett’s Test Results

b. Kaiser-Meyer-Olkin (KMO) Test

KMO test is used to measure data adequacy in factor analysis 20. The results of the KMO in Table 6. indicate that the KMO value is 0,671, so Kansei Words is sufficient for further analysis because the KMO value is greater than 0,5.

Table .Kaiser-Meyer-Olkin (KMO) Test Results

c. Measure of Sampling Adequacy (MSA)

MSA is used to determine the extent to which Kansei Words in product design can be accurately predicted by other variables with minimal error 20. The results of the MSA in Table 7. indicate that Kansei Words are worthy of further analysis because the MSA values of all Kansei Words are greater than 0,5.

Table . Measure of Sampling Adequacy (MSA) Results

d. Factoring Process

The factoring process uses the Principal Component Analysis (PCA) method, which serves to simplify the data by converting correlated Kansei Words into a smaller set of independent variables 20. Based on the percentage of each Kansei Word in the new factors in Table 8., it can be seen the percentage of variance of each Kansei Word that can be explained by the formed factors. For example, the Kansei Word Sturdy has an extraction value of 0,7999; which means that 79,99% of the Kansei Word variance can be explained by the formed factor. The highest extraction value is in the Kansei Word Comfortable at 90,8%, and the lowest extraction value is in the Kansei Word Concise at 0,413. In addition to the extraction value, there is an initial value for each Kansei Word of 1,000, which means that all Kansei Word variance has a percentage of 100% before extraction.

Table . Communalities Results

The results of the total variance explained in Table 9. indicate that the number of factors formed is determined by the initial eigenvalue, which is the amount of total variance that can be explained by the factors formed. Of the 13 factors, only 3 factors were formed because they had a total initial eigenvalue of more than one.

Table . Total Variance Explained Results

e. Rotation Process

The rotation process uses the Varimax method, which serves to clarify the factor structure by maximizing the loading value on one factor and minimizing cross-loading, so that Kansei Words can be more clearly grouped into the most relevant factors, which can facilitate the interpretation and utilization of factors in product design development 20. The results of the rotated component matrix in Table 10. indicate that 13 Kansei Words have been grouped into factors formed based on the highest loading factor values. The loading factor value for each Kansei Word uses a minimum limit of 0.4, where a higher loading factor indicates a stronger correlation of the Kansei Word toward the factor 21.

Table . Rotated Component Matrix Results

Based on the placement of Kansei Words on the factors formed in Table 11, it can be seen that factor 1 consists of 5 Kansei Words, factor 2 consists of 5 Kansei Words, and factor 3 consists of 3 Kansei Words. The naming of the factors is determined based on the Kansei Word with the highest factor loading value, where factor 1 is named Agility, factor 2 is named Comfortable, and factor 3 is named Affirmation.

Table . Kansei Words Placement in the Identified Factors

2. C onjoin t Analysis

Conjoint analysis is a stage in research used to identify user preferences for various product design elements20.

a. Stimuli Card Design Preparation

The stimuli card design consists of several combinations of 10 elements and 20 sub-elements of the rollator walker product, as shown in Table 12.

Table . Elements and Subelements of the Rollator Walker Product

The results of the stimuli card design preparation can be seen in Table 13.

Table . Stimuli Card Design

b. Utility and Importance Values

The utility value indicates the total level of satisfaction users obtain from using a product, while the importance value indicates the design attributes that respondents consider most important in choosing a product 20. Thus, the combination of utility and importance values can help researchers identify the most preferred sub-elements of rollator walker product design and the most important design elements of rollator walker products for the preferences of the elderly. The results of the utility value in Table 14. indicate that the design sub-elements of the rollator walker product were selected based on the highest utility value for each Kansei Word. The overall summary is the average utility value of the 13 Kansei Words that assess the level of satisfaction obtained by respondents for the development of the rollator walker product.

Table . Utility Value Results

The results of the importance values in Table 15. indicate that the most important design elements of the rollator walker can be identified from the highest importance values in each Kansei Word. The overall summary shows the most important factors from lowest to highest in the design elements of the rollator walker.

Table . Importance Value Results

c. Pearson’s R and Kendall’s Tau

Pearson’s R and Kendall’s Tau tests were used to measure the strength of the correlation between product design elements and Kansei Words 8. Pearson’s R and Kendall’s Tau tests were used to measure the strength of the relationship between product design elements and Kansei Words [8]. The results of the Pearson's R and Kendall's Tau in Table 16. indicate that the Pearson's R and Kendall's Tau values for each Kansei Word are greater than 0,5 with a significance value of less than 0,05. Therefore, an overall summary shows that the correlation between the rollator walker product design elements and Kansei Word is strong.

Table . Pearson’s R dan Kendall’s Tau Test Results

From the results of factor analysis and conjoint analysis, the subsystems (factors) and components (elements) of the rollator walker can be determined, as shown in Table 17.

Table . Subsystems dan Components Rollator Walker

G. Detail ed Design

The fourth stage of product development is detailed design, which involves specifying the shape, materials, and tolerances of all product components, and identifying all standard components 10. The product dimensions used in the development of the rollator walker are based on anthropometric data of elderly people in Indonesia using the average percentile or P-50, as this represents the average size of elderly people in Indonesia. The body dimensions used as a reference for the development of the rollator walker product are elbow height, shoulder width (width of the shoulders/bi-deltoid width), hip width, sitting shoulder height, popliteal height, popliteal buttocks, hand width, hand length, and forearm length. Using these 9 body dimensions as a reference, a product mapping can be developed to translate emotional preferences into more detailed technical specifications, as shown in Table 18.

Table . Product Mapping Rollator Walker

The overall design of the rollator walker product is shown in Figure 2.

Figure . Product Design Rollator Walker

Based on the rollator walker product design that has been developed, a comparison was made between the standard walker product design used at the Hargo Dedali Nursing Home and the rollator walker product design developed from the standard walker, as shown in Table 19. The standard walker and rollator walker product designs can be seen in Figure 3.

1. (b)

Figure . (a) Product Design Standard Walker (b) Product Design Rollator Walker

Table . Comparison of Standard Walker with Rollator Walker

H. Testing and Repair

The fifth stage of product development is testing and refinement, which involves building and evaluating early production versions of the product 10. In this study, simulations of rollator walker use were created with the help of artificial intelligence and visualized step by step using images from AutoCAD software, providing an overview of user interaction with the product without the need for direct testing, as shown in Table 20.

Table . Simulation of Rollator Walker Product Use

After simulating the use of the rollator walker product, an evaluation was conducted using a questionnaire to assess respondents opinions of the initial product, which was a standard walker, and the product that had been developed from the standard walker, which was a rollator walker based on the Kansei Word factor. The results of the second questionnaire were tested using Stuart-Maxwell's Marginal Homogeneity test. Based on the results of the Stuart-Maxwell Marginal Homogeneity test in Table 21., it can be seen that the Asymp. Sig. (2-Tailed) value for the three Kansei Word factors is greater than 0,05; thus, there is no difference between the emotional needs of the elderly and the rollator walker design that has been developed from the standard walker.

Table . Marginal Homogeneity Stuart-Maxwell Test Results

Conclusion

Based on the research that has been conducted, it can be seen that the emotional needs of the elderly at the Hargo Dedali Nursing Home regarding the use of rollator walkers are represented in the form of 13 Kansei Words obtained through previous research, where each Kansei Word is related to a specific product element to explore the emotional preferences of the elderly, which will then be used as a basis for the development of rollator walker products. The results of the emotional preferences of the elderly at the Hargo Dedali Nursing Home were obtained after the rollator walker product sample assessment questionnaire results had undergone validity and reliability testing, factor analysis, and conjoint analysis. These emotional preferences point to the sub-elements of the rollator walker product that are most preferred by the elderly, where each sub-element of the rollator walker product is found in the product sample that has been previously assessed by the elderly. The results of the elderly's emotional preferences can be seen from the highest utility value. In developing the conceptual design of the rollator walker, the average anthropometric measurements of elderly people in Indonesia were used so that the product developed could meet ergonomic requirements. Each element of the rollator walker product is interrelated to fulfill the product development objectives of supporting independence and improving quality of life. Simulations of the use of the rollator walker product were created with the help of artificial intelligence and visualized in stages through image cutouts from AutoCAD software, providing an overview of the interaction between the user and the product without the need for direct testing. The product usage simulation consisted of 8 mechanisms, each of which was accompanied by a description of how it works and illustrations depicting the stages of product use. Further research is recommended to develop the rollator walker product design concept in the form of a prototype and to calculate the cost of developing the rollator walker product.

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