Abstract: Objective To construct a patient decision aid (PtDA) for exercise training in patients with chronic obstructive pulmonary disease (COPD) and explore its impacts on decision-making quality of patients'exercise regimens. Methods The development of the PtDA for exercise training in COPD patients was accomplished through literature analysis, the Delphi method, and user surveys, followed by an intervention study. A total of 59 inpatients with COPD were included as study subjects. The control group received routine care along with general exercise training guidance, while the intervention group received routine care combined with shared decision-making for exercise training based on the PtDA. The decision conflict and decision preparedness levels of patients in both groups were compared before the intervention and on the day of discharge. The exercise self-efficacy of patients was measured before intervention, on the day of discharge, and 1 month and 3 months after discharge. Results The intervention group had significantly lower scores for decision conflict and significantly higher scores for decision preparedness and exercise self-efficacy compared with the control group (P < 0.05). Conclusion The PtDA for exercise training can improve decision conflict and decision preparedness in COPD patients, enhance their exercise self-efficacy levels, and provide references for healthcare professionals in improving exercise adherence.