differences between the scores before and at the end of treatment were compared with the t test for paired samples if the data had a normal distribution (ie, Z-score for both skewness and kurtosis ≤1.96), otherwise using the Wilcoxon signed rank test. Differences were considered to be statistically significant if P ≤ .05. Data are expressed as mean ± standard deviation (SD). For each question, the total number of answers (n) is shown, if different from 20.