highly significantp < 0.001
The Confidence (CO) domain showed a substantial improvement from a mean of 6.3 ± 2.7 to 7.5 ± 2.4, and the Satisfaction (SA) domain increased markedly from 6.5 ± 2.9 to 8.9 ± 1.6, both with highly significant p -values ( p < 0.001).