A cross-sectional study assessed self-management in 370 patients with systemic lupus erythematosus (SLE) from three hospitals in Henan Province from March to September 2024. The mean age of the patients was 38.16 ± 12.81 years and the mean disease duration was 4.65 ± 3.18 years. Disease activity was absent or minimal in 36.2% of patients, moderate in 31.4% and moderate to high in 32.4%. The mean self-control score was 59.06 ± 16.75, with subscores for medication 9.91 ± 3.45, disease surveillance 10.01 ± 3.56, daily life 29.40 ± 9.35, and reproductive health 9.74 ± 3.84. Key influencing factors included disease activity, education level, marital status, self-efficacy, illness perception, coping styles, family support, and social support, which explained 52.4% of the variance. The study recommends interventions to increase self-efficacy, optimize illness perception, promote positive coping, and strengthen social and family support.